Analysis of clinical characteristics, rationale, and management of critically ill obstetric patients transferred to ICU.

ABSTRACT

OBJECTIVE: To evaluate the clinical and demographic characteristics, rationale for transfer of critically ill obstetric patients to intensive care unit and their management therein. METHODS: The observational retrospective case series study was conducted at Shaheed Mohtarma Benazir Bhutto Medical University, Larkana, Pakistan, and comprised critically ill female patients transferred to intensive care unit from the department of Obstetrics and Gynaecology between August 2011 and June 2013. The data was collected on pre-designed proforma which included demographic characteristics of patients, their symptomatology and initial diagnosis, intervention in the department, continuing or subsequent complications/reasons for admission to intensive care unit, management and stay there and, finally, outcome. Data was analysed using SPSS 21. RESULTS: The mean age of 150 patients in the study was 30.3±5.047years,mean parity was 2.49±2.207.The most common condition affecting women and leading to their transfer to intensive care was eclampsia/pre-eclampsia in 80(53.33%) followed by bleeding disorders in 25(16.65%) and septic shock in 24(16%). The mean stay in intensive care was 4.47±2.53 days, and 38(25.3%) patients required ventilator support, while 112(74.7%) were managed with oxygen and inotropic support. The overall maternal mortality rate was 41(27.3%), which included 19(16.9%) patients managed without ventilator, and 22 (57.8%) managed with ventilator (p<0.05). CONCLUSIONS: Hypertensive and bleeding disorders were the main reasons for transfer of obstetric patients to intensive care unit, and maternal mortality was high among patients treated on ventilator support.