Profile of Obstetric Patients in Intensive Care Unit: A Retrospective Study from a Tertiary Care Hospital in Peshawar

Abstract

OBJECTIVES To examine demographic characteristics, diagnosis on admission, and clinical outcomes in terms of morbidity and mortality of all those obstetric patients who were shifted to the Intensive care unit. METHODOLOGY This retrospective study was conducted in Gynae Unit A, Medical and Surgical intensive care units of Khyber Teaching Hospital Peshawar from 1st January 2021 to 31st December 2022. All the obstetric patients admitted to medical or surgical intensive care units were included, i.e., pregnant women or women admitted within six weeks after delivery to medical or surgical ICUs. Data about the patient’s demographics, obstetric/medical history, diagnosis on admission, reason for shifting to Intensive care units, course and treatment, ICU course, length of stay, outcome, and maternal mortality were obtained.RESULTSThe ICU admission rate of obstetric patients in the study period was 0.7%. The age group of 26-30 years was most commonly seen in our study, where 35(40%) of our cases fell, followed by the 21-25 age group (19.5%).27(31%) of our patients were primigravidas and 60(69%) were multigravidas.21(24%) were antenatal,65(75%) were postnatal and 1(1%) was ectopic. Postpartum hemorrhage was the most common indication(24%) for which patients were referred to the intensive care unit, followed by Eclampsia in 15(17%) and placenta accreta in 13(15%). Causes of mortality for the ICU admissions were shock and ARDS in 1(7%) each, DIC in 5(33%), and Cardiac arrest in 8(53%) cases. Fifteen patients expired in the intensive care unit during the study period, making the mortality rate 17%. CONCLUSION Strengthening critical care is important for saving the high-risk obstetric population. A structured ICU with an interdisciplinary approach is necessary to reduce high-risk obstetric mortality.