Intensive care admissions due to severe maternal morbidity

Abstract

Maternal morbidity is a quality of care indicator. The frequency of severe maternal morbidity that requires an intensive care management has increased, due to an increase in maternal age. To describe the severe and acute maternal morbidity spectrum that requires an intensive care management in a University Hospital. Review of medical records of 89 pregnant women with a mean age of 29 years, admitted to an Intensive Care Unit (UCI) between 2006 and 2010. Mean gestational age on admission was 32 weeks. The main comorbidities identified were chronic hypertension (13.5%), hypothyroidism (4.5%) and coagulopathies (6.7%). Severe preeclampsia, sepsis and obstetric hemorrhage were the main causes of admission. Length of stay ranged from 1 to 28 days. Seventy eight percent of patients were admitted in the immediate postnatal period. Mechanical ventilation was required in 24% of patients for a median of three days. The longer unit lengths of stay were observed in patients with preeclampsia and non-obstetric severe sepsis (pyelonephritis and pneumonia). Seven abortions and seven perinatal deaths were recorded. The latter were mainly secondary to severe preeclampsia/ HELLP syndrome. Neonatal morbidity was related to prematurity (19% hyaline membrane, 18% persistent ductus and 4% cerebral hemorrhage). There were no maternal deaths. Preeclampsia and its complications were the main causes of maternal ICU admission. In this series, there were no maternal deaths and the perinatal survival rate was 92%.