Contributory Factors for Obstetric ICU Admission: A Prospective Cross-sectional Study

Abstract

Introduction: The physiological changes of pregnancy can turn pathological leading to Intensive Care Unit (ICU) admission of mother. The contributory factors to these ICU admissions need to be properly identified so that quality of obstetric services could be improved. Aim: To identify contributory factors to obstetric ICU admission. Materials and Methods: A prospective observational study was conducted in a multidisciplinary ICU of a tertiary care hospital of East Delhi, India. Maternal characteristics of women requiring ICU admission as well as contributory factors to ICU admission were observed and analysed. ‘Contributory factor’ was defined as modifiable component of health system and quality of care covering organisational, personnel and social factors. Descriptive data was tabulated as absolute figures and percentages. Results: Hypertensive disorder of pregnancy was most common primary diagnosis of ICU admission. Massive intraperitoneal haemorrhage leading to Disseminated Intravascular Coagulation (DIC) and multiorgan failure was major cause of death in ICU admitted patients. Delay in referral and lack of transportation were found to be most contributory (84%) in obstetric ICU admission. Conclusion: Social factors are major hurdle in achieving safe motherhood in India. There is a strong need of sensitisation regarding primary obstetric care among illiterate and poor women to decrease obstetric ICU admissions.

Keywords

• maternal intensive care unit admissions
• maternal morbidity
• obstetric critical care