[Severe maternal morbidity in an obstetric ICU in Recife, Northeast of Brasil]

Abstract

Objectives: To evaluate patients admitted with near miss maternal mortality criteria to an Obstetric ICU.

Methods: This is a secondary analysis of a study conducted in an Obstetric ICU of IMIP (Recife, Pernambuco), from February 2003 to February 2007, from which 291 patients with near miss criteria or severe maternal morbidity were selected. Data concerning cause of admission, time of admission related to delivery, age, parity, education, prenatal care, associated clinical conditions, gestational age at admission and delivery, diagnosis, complications and procedures as well as length of ICU stay were collected.

Results: The most common reasons of admission were hypertensive disorders (78.4%), haemorrhage (25.4%) and infection (16.5%). The great majority of patients was admitted after delivery (80.4%) and transferred from other units. Patient age ranged from 12 to 44 years, median of parity was 1 and prenatal care was absent in 9.9% of cases. Cesarean section was the mode of delivery in 68.4%. Medical conditions were present in 18.7% of the patients, 37% required blood product transfusions, 10.8% vasoactive infusions, 9.1% mechanical ventilation and 13.4% a central line. Eclampsia was present in 38.8 % of the patients, hemorrhagic shock in 27.1%, renal failure in 11.7%, and pulmonary edema in 9.1% and respiratory failure in 6.5%.

Conclusion: Patients classified as near miss maternal mortality constitute an important group admitted to an Obstetric ICU. Better information about these patients is fundamental to improve care and prevent maternal mortality.