Study of obstetric patients admitted to medical intensive care unit in a tertiary care teaching hospital

Abstract

Background: Obstetric critical care is of utmost importance and interventions in intensive care unit (ICU) can improve the maternal outcome. The efficient scoring systems for such critically ill patients are the need of the hour. Methods: We prospectively studied the characteristics and outcome of 75 critically ill obstetrics patients admitted to the ICU of our tertiary care teaching hospital. Results: Their mean age was 27.2 ± 5.0 years. Hypertensive diseases of pregnancy (n = 51; 68%) were the most common reasons for ICU admission; hypothyroidism (13.3%) was the most common comorbid condition. The mean ICU stay and mean hospital stay were 4.6 ± 2.5 days and 8.2 ± 4.1 days, respectively. Compared to survivors, patients who died had a significantly higher sequential organ failure assessment (SOFA) score (6.5 ± 0.8 vs. 2.5 ± 1.1; P < 0.0001) and acute physiology and chronic health evaluation II (APACHE II) score, respectively. The predicted mortality by APACHE II score was 11.3 ± 6.4 and the observed mortality rate was 21.3% (P < 0.0001). Conclusions: Hypertensive disorders of pregnancy were the most common indication for ICU admission. The SOFA, APACHE II and length of hospital stay were the most important predictors of maternal mortality.

Keywords

• acute physiology and chronic health evaluation ii score
• critical care
• india
• intensive care unit
• obstetrics
• sequential organ failure assessment score