Study of Obstetric Patients Admitted To Intensive Care Unit (ICU) In a High Volume Tertiary Care Center
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 1
Abstract
Pregnancy though physiological and can be associated with major maternal morbidity with potential catastrophic consequences requiring utilization of facilities of Intensive Care Unit (ICU) Reports regarding such admissions are few from developing countries. Objective: To study the indication for admission, intervention and outcome of obstetric patients admitted to intensive care unit and also to identify risk factors for admission to intensive care unit at Government General Hospital, Kakinada, AP, India. Methods: A hospital based descriptive observational study was conducted in month of April and May 2017. All obstetric admissions to the ICU up to 42 days postpartum were included. Data obtained included demography, obstetric history, pre-existing medical problems, indication for ICU admission, intervention in ICU and outcome. Risk factors were assessed by comparing cases with control which included women who delivered before and after the indexed cases. Results: A total of 200 obstetric patients admitted in ICU during the study period. This accounts for 20% of total hospital deliveries and 12.5% of all ICU admissions. Eighty Five percent of the patients were admitted due to hypertensive disorders of pregnancy. Fourty Seven percent patients were of obstetric haemorrhage. Heart diseases topped the list with 8% in non-obstetric group. Risk factors for admission included lesser gestational age, Caesarean-section, blood loss and co-morbid conditions of the patient. Mean age was 24.5±4.8 years; Inotropic support was received by six patients (6%), CVP monitoring was done in three patients (3%). Ventilator support was needed in six (6%). There were three cases (3%) of mortality which accounts for 2.09% of total ICU mortality. Twenty Eight patients (28%) were referred from other centres. Conclusion: Hypertensive disorders of pregnancy, Obstetric haemorrhage and Heart disease were the most common indications of ICU admissions. Risk factors for admission included lesser gestational age, caesarean section, blood loss, and co- morbid conditions of the patients. Optimal outcome was achieved with combined effort of multidisciplinary team.
Authors and Affiliations
Dr. Anuragamayi Yelamanchili, Dr. Karunakumari Cherukuri, Dr. Priyanka . K
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