[Year:2018] [Month:July-December] [Volume:2] [Number:2] [Pages:6] [Pages No:82 - 87]
Background: The goals of management of critically ill obstetric patients involve intensive monitoring and physiological support for patients with life threatening but potentially reversible conditions. Intensive care unit (ICU) is highly specified and sophisticated area of a hospital which is specifically designed, staffed, located, furnished, and equipped, dedicated to the management of critically sick patient, injuries, or complications. The aim of this study is to know the frequency of ICU admissions, to analyze the disease comorbidity related to medical and obstetrical problems, to segregate cause of morbidity, and also to identify and adopt risk reduction strategies.
Methods: This observational study was conducted on 35 ICU patients in our institute from 1 December 2016 to 31 May 2018. Our study was divided into two groups. In group I, the intervention was done first followed by ICU intervention and, in group II, ICU stabilization was done prior to surgical intervention. The parameters noted were age, parity, diagnosis on admission, and associated medical and surgical comorbidity; reason for ICU admission, any surgical procedure performed, antenatal, and postnatal admission; details of treatment given like ventilator support, blood and blood components' transfusion, inotropic support, and dialysis. Neonatal outcome was also noted and the total duration was noted. Parameters noted after ICU admissions were cost, duration of stay, patient outcome, review of mortality, and area of improvement.
Results: There were 17.1% of mortalities observed in our study. The commonest cause for maternal mortality was multi-organ dysfunction (33.3%) followed by hypertensive disorder of pregnancy (16.7%), peripartum cardiomyopathy (16.7%), acute fatty liver of pregnancy (16.7%), and septic shock (16.7%). Severe anemia, cardiac diseases, sepsis, need for a caesarean delivery, and more than one diagnosis on admission are the other risk factors for ICU admission.
Conclusion: The majority of the survivors (69%) were discharged satisfactorily from the hospital. There is a need for training in emergency obstetrics so that the complication can be managed right at the time of occurrence. There is a need to train obstetricians in obstetric medicine and critical care to do justice to these critically ill pregnant women.