Critically Ill Obstetric Patients in Intensive Care Unit: A Single-center Ten-year Retrospective Cohort Study

Abstract

Objective:In critically ill obstetric patients (COPs), an exacerbation of both a pre-pregnancy disease and newly emerging additional diseases during and after pregnancy may occur. There are limited data on intensive care unit (ICU) follow-up of COPs in literature. The aim of this retrospective study was to evaluate the COPs that we have followed in ICU in the last 10 years, to investigate the frequency and the reasons of admission to the ICU, and the factors affecting outcomes and mortality.Method:This study was planned retrospectively on COPs who were followed up in the ICU of University of Health Sciences Turkey, İstanbul Bağcılar Training and Research Hospital between 2011 and 2021.Results:A total of 220 patients aged 18-50 years, who were diagnosed as COPs, were included in the study. The most frequent admission type to the ICU was after caesarian section (n=129, 58.6%) and the most frequent indication was obstetric hemorrhage (n=56, 25.4%). The average length of stay in the ICU was 2 days (3.5±4), the average length of hospitalization was 6 days (9.1±7.9), the rate of discharge from the ICU was 95.5%, and mortality rate was 4.5%. Gestational age was lower (p<0.05) and first 24 hours acute physiological and chronic health evaluation II and sequential organ failure assessment scores were found significantly higher in the mortal cases (p<0.001).Conclusion:The most frequent admission type to ICU was due to cesarean section (n=129, 58.6%) and the most common indication for admission was obstetric hemorrhage (n=56, 25.4%). Mortality rate was determined as 4.5%. In COPs, we should be prepared for complications that may arise, and these patients should be followed up and treated appropriately.

Keywords

• critically ill obstetric patient
• intensive care unit
• maternal mortality