A RETROSPECTIVE ANALYSIS OF CLINICAL DIAGNOSIS, PREDICTABILITY AND FETO MATERNAL OUTCOME IN A CRITICAL PATIENTS ADMITTED IN OBSTETRIC INTENSIVE CARE UNIT IN A TERTIARY CARE CENTRE
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2014, Vol 3, Issue 3
Abstract
[b]INTRODUCTION: [/b]Care of the critically ill parturient is a unique challenge in obstetrics particularly because of its unpredictability. Hemorrhage, toxemia, anemia and septicemia are common causes of mortality and morbidity in these patients. Obstetric critical care in developing countries continues to be radically different from developed countries. [b]AIMS AND OBJECTIVES[/b]: To analyze all cases of critically ill obstetric patients admitted to an obstetric intensive care unit in relation to causes for admissions, interventions required, course during their ICU stay and fetal maternal outcome. [b]MATERIALS AND METHODS[/b]: A one year retrospective analysis of all obstetric admissions to the ICU at our referral hospital was conducted, observations made and results were analyzed. [b]RESULTS AND ANALYSIS[/b]: There were 24 ICU admissions with mean age of 25.21±4.075 years and mean gestational age of 36.04±3.862 weeks. Postpartum admissions were significantly higher (83.33%, n=20, P<0.05) with more patients presenting with obstetric complications (91.66%, n=22, P<0.01) as compared to medical complications (8.32%, n=2). Obstetric hemorrhage (n=15, 62.5%) and hemodynamic instability (n=20, 83.33%) were considered to be significant risk factors for ICU admission (P=0.000). Inotropic support was required in 22 patients (91.66%) while 17 patients (70.83%) required ventilatory support. The mean duration of ventilation (30.17±21.65 h) and ICU stay (39.42±33.70 h) were of significantly longer duration in survivors (P=0.01, P=0.00 respectively) versus non-survivors. The observed mortality n=10, 41.67% was significantly higher since ours is a referral tertiary center and delay in reaching the tertiary center from the place of occurrence of the mishap is a usual occurrence. [b]CONCLUSION: [/b]Obstetric hemorrhage leading to hemodynamic instability remains the leading cause of ICU admissions and maternal mortality
Authors and Affiliations
Vijayasree M, Madhuri K. , Venugopal N. C. H, Narasinga Reddy, Dilip Rampure
Keywords
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- EP ID EP117278
- DOI 10.14260/jemds/2014/1872
- Views 94
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