Obstetric intensive care admissions: a 12-year review in a tertiary care centre

Abstract

Objective: To review all pregnant women who required admission to an Intensive Care Unit (ICU) during pregnancy, childbirth or puerperium.

Study design: Retrospective follow-up study in a tertiary care centre in The Netherlands. The files of all obstetric ICU admissions over the period 1990-2001 were reviewed.

Results: Over these 12 years, 142 women required ICU admission (0.76% of all deliveries, 0.70% of all adult ICU admissions). The most common reasons for ICU admission were (pre)eclampsia (62.0%) and obstetric haemorrhage (18.3%). Twenty-seven out of 142 women (19.0%) were of non-caucasian origin. The most common therapeutic interventions were transfusion of erythrocytes (66.2%), caesarean section (50.7%) and artificial ventilation (44.4%). We observed seven maternal deaths (4.9%).

Conclusion: We need better information about high-risk obstetric patients in order to prevent severe maternal morbidity and to improve maternal care. The high number of non-caucasian women requiring ICU admission indicates the need for a study into the role of ethnicity. We have initiated a nationwide confidential enquiry into the causes of severe maternal morbidity.