Obstetric patients in intensive care unit: Perspective from a teaching hospital in Pakistan

Abstract

Objective: Review of obstetric cases admitted to the intensive care unit.

Design: Ten year retrospective review of individual patients' medical records.

Participants: Records of obstetric patients admitted from 2005-2014.

Setting: Aga Khan University Hospital Karachi.

Main outcome measures: Diagnosis at the time of admission, associated risk factors, and intervention required aspects of management and rate of mortality.

Findings: A total of 194 obstetric patients were admitted out of which 86.2% of patients had ventilator support. Mortality was not seen to be significantly associated with parity and antenatal/postnatal status. The median age of patients was 34 years, minimum length of stay was 24 hours and maximum stay was 53 days. Sixty one percent of patients were admitted to with organ system failure. The overall mortality rate was 21.64% (42/194). The mortality rate was five times more likely in patients who had gastro-intestinal complication {Odds Ratio=4.87; 95%CI: 1.65-14.36}. The largest group of patients {28.4%} presented with hematological diagnosis.

Conclusion: When the intensive care unit admission became essential, primary diagnosis included: postpartum hemorrhage, hypertensive disorders, sepsis and infectious diseases. An increased vigilance of high-risk pregnant women and a stabilization of their condition before intervention is administered, improves the outcome of these women.

Keywords: critical care; obstetrics; pregnancy.