Role of mechanical ventilation in critically ill obstetric patients

Abstract

Objective To analyze the characteristics and outcomes of critically ill obstetric patients who required mechanical ventilation. Methods The data of critically ill obstetric patients, who required mechanical ventilation at obstetric intensive care unit in a tertiary hospital from January 1999 to January 2008, were retrospectively collected. The data included general information, the causes and indication of ventilation, the clinical information of pregnancy women being supported with mechanical ventilation, ventilation mode, ventilation index, the number of times of removal of mechanical assistance, and so on. Results There were 114 women included in the present study. Ten women were un-delivery when requiring mechanical ventilation, eight of whom suffered from co-existed underlying disease, and six of whom result in stillbirth. The major obstetric diseases requiring mechanical ventilation were preeclampsia or eclampsia with severe complications (34.21%), and hemorrhagic shock (27.19%); while the major non-obstetric underlying disease were rheumatic heart disease with heart failure (6.14%) and severe hepatitis (6.14%). The indications for mechanical ventilation were hypoxemia (62.28%) and hypoventilation (37.72%). Twenty-six patients were died and the mortality rate was 22.81%. Conclusions The major obstetric diseases requiring mechanical ventilation were preeclampsia or eclampsia with severe complications and hemorrhagic shock in critically ill obstetric patients. The best mode of mechanical ventilation was SIMV+ PSV+ PEEP, which can reduce the pulmonary edema of the patients. The obstetricians and intensive care specialists should pay attention to the mechanical ventilation characteristic of the critically ill obstetric patients. Key words: Ventilators, mechanical; Pregnancy, high-risk; Intensive care units