Obstetric Patients Requiring Intensive Care: A One Year Retrospective Study in a Tertiary Care Institute in India

Background and Objectives. Critically ill obstetric patients are a particularly unique cohort for the intensivist. The objective of this study was to review the indications for admission, demographics, clinical characteristics, and outcomes of obstetric patients admitted to intensive care unit of a...

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Main Authors: Niyaz Ashraf, Sandeep Kumar Mishra, Pankaj Kundra, P. Veena, S. Soundaraghavan, S. Habeebullah
Format: Article
Language:English
Published: Hindawi Limited 2014-01-01
Series:Anesthesiology Research and Practice
Online Access:http://dx.doi.org/10.1155/2014/789450
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spelling doaj-205f2da949954781be3443d84d432fbf2020-11-24T23:37:49ZengHindawi LimitedAnesthesiology Research and Practice1687-69621687-69702014-01-01201410.1155/2014/789450789450Obstetric Patients Requiring Intensive Care: A One Year Retrospective Study in a Tertiary Care Institute in IndiaNiyaz Ashraf0Sandeep Kumar Mishra1Pankaj Kundra2P. Veena3S. Soundaraghavan4S. Habeebullah5Department of Anaesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Dhanvantri Nagar, Pondicherry 605006, IndiaDepartment of Anaesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Dhanvantri Nagar, Pondicherry 605006, IndiaDepartment of Anaesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Dhanvantri Nagar, Pondicherry 605006, IndiaDepartment of Obstetrics and Gyanaecology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Dhanvantri Nagar, Pondicherry 605006, IndiaDepartment of Obstetrics and Gyanaecology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Dhanvantri Nagar, Pondicherry 605006, IndiaDepartment of Obstetrics and Gyanaecology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Dhanvantri Nagar, Pondicherry 605006, IndiaBackground and Objectives. Critically ill obstetric patients are a particularly unique cohort for the intensivist. The objective of this study was to review the indications for admission, demographics, clinical characteristics, and outcomes of obstetric patients admitted to intensive care unit of a medical college hospital in southern India and to identify conditions associated with maternal mortality. Design. Retrospective analysis of pregnant/postpartum (up to 6 weeks) admissions over a 1-year result. We studied 55 patients constituting 11.6% of mixed ICU admissions during the study period. Results. The mean APACHE (acute physiology and chronic health evaluation) II score of patients at admission was 11.8. Most of the patients (76%) were admitted in the antepartum period. The commonest indications for ICU admission were obstetric haemorrhage (51%) and hypertensive disorders of pregnancy (18%). 85% of patients required mechanical ventilation and 78% required inotropic support. Conclusions. Maternal mortality was 13%, and the majority of the deaths were due to disseminated intravascular coagulation and multiorgan failure, following an obstetric haemorrhage. A dedicated obstetric ICU in tertiary hospitals can ensure that there is no delay in patient management and intensive care can be instituted at the earliest.http://dx.doi.org/10.1155/2014/789450
collection DOAJ
language English
format Article
sources DOAJ
author Niyaz Ashraf
Sandeep Kumar Mishra
Pankaj Kundra
P. Veena
S. Soundaraghavan
S. Habeebullah
spellingShingle Niyaz Ashraf
Sandeep Kumar Mishra
Pankaj Kundra
P. Veena
S. Soundaraghavan
S. Habeebullah
Obstetric Patients Requiring Intensive Care: A One Year Retrospective Study in a Tertiary Care Institute in India
Anesthesiology Research and Practice
author_facet Niyaz Ashraf
Sandeep Kumar Mishra
Pankaj Kundra
P. Veena
S. Soundaraghavan
S. Habeebullah
author_sort Niyaz Ashraf
title Obstetric Patients Requiring Intensive Care: A One Year Retrospective Study in a Tertiary Care Institute in India
title_short Obstetric Patients Requiring Intensive Care: A One Year Retrospective Study in a Tertiary Care Institute in India
title_full Obstetric Patients Requiring Intensive Care: A One Year Retrospective Study in a Tertiary Care Institute in India
title_fullStr Obstetric Patients Requiring Intensive Care: A One Year Retrospective Study in a Tertiary Care Institute in India
title_full_unstemmed Obstetric Patients Requiring Intensive Care: A One Year Retrospective Study in a Tertiary Care Institute in India
title_sort obstetric patients requiring intensive care: a one year retrospective study in a tertiary care institute in india
publisher Hindawi Limited
series Anesthesiology Research and Practice
issn 1687-6962
1687-6970
publishDate 2014-01-01
description Background and Objectives. Critically ill obstetric patients are a particularly unique cohort for the intensivist. The objective of this study was to review the indications for admission, demographics, clinical characteristics, and outcomes of obstetric patients admitted to intensive care unit of a medical college hospital in southern India and to identify conditions associated with maternal mortality. Design. Retrospective analysis of pregnant/postpartum (up to 6 weeks) admissions over a 1-year result. We studied 55 patients constituting 11.6% of mixed ICU admissions during the study period. Results. The mean APACHE (acute physiology and chronic health evaluation) II score of patients at admission was 11.8. Most of the patients (76%) were admitted in the antepartum period. The commonest indications for ICU admission were obstetric haemorrhage (51%) and hypertensive disorders of pregnancy (18%). 85% of patients required mechanical ventilation and 78% required inotropic support. Conclusions. Maternal mortality was 13%, and the majority of the deaths were due to disseminated intravascular coagulation and multiorgan failure, following an obstetric haemorrhage. A dedicated obstetric ICU in tertiary hospitals can ensure that there is no delay in patient management and intensive care can be instituted at the earliest.
url http://dx.doi.org/10.1155/2014/789450
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