Characteristics of Critically ill Obstetric Patients Admitted to the ICU at a Tertiary Care Centre

Abstract

Objective: To ascertain the characteristics, admission indications, interventions, and outcomes of obstetric patients admitted to ICU. Methodology: A retrospective, descriptive study was conducted at Lady Reading Hospital's ICU in Peshawar, Pakistan (January 1 to December 31, 2022). During this time, a total of 1560 patients were received in the ICU, out of which 132 full filled our inclusion and exclusion criteria. Characteristics of patients, reasons for admission, interventions, demographic information, obstetric history, length of stay, and outcomes were collected through a retrospective review of medical records. Statistical analysis was performed using SPSS software version 21.0. Results: Among the 1,560 admissions in ICU, 132 were obstetric cases (8.5% of all ICU admissions). Majority of these patients had a mean age of 27.05 ± 6.23 years, with mean ICU stay duration of 6.55 ± 7.05 days. Among these, hypertensive disorders of pregnancy were identified in 47 patients (35.6%). Obstetric hemorrhagic disorders accounted for admission in 40 patients (30.3%). Out of the 132 patients, 26 (19.6%) did not survive. Highest mortality rates were of those admitted with fulminant hepatic failure (2 patients, 66.7%). Among patients admitted for direct obstetric reasons, post-natal septicemia caused the highest mortality (3 patients, 37.5%). Ventilatory support was required by 113 patients (85.6%) and vasopressor support was administered to 87 patients (65.9%) of the patients. Conclusions: To decrease maternal mortality and improve healthcare for pregnant individuals, it is crucial to focus on hypertensive disorders of pregnancy and obstetric hemorrhage. Addressing these issues, along with providing effective post-natal sepsis treatment, can contribute to a reduction in mortality rates. Keywords: Obstetric hemorrhage, Pre-Eclampsia, Post-natal septicemia, Mortality