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产科患者入住重症监护病房的指征及结局:一项7年回顾性研究

Indications and outcome for obstetric patients' admission to intensive care unit: a 7-year review.

作者信息

Lataifeh I, Amarin Z, Zayed F, Al-Mehaisen L, Alchalabi H, Khader Y

机构信息

Department of Obstetrics and Gynaecology, Jordan University of Science and Technology, Irbid, Jordan.

出版信息

J Obstet Gynaecol. 2010 May;30(4):378-82. doi: 10.3109/01443611003646298.

Abstract

The objective of this retrospective study was to investigate the indications, interventions and clinical outcome of pregnant and newly delivered women admitted to the multidisciplinary intensive care unit at the King Abdullah University Hospital in Jordan over a 7-year period from January 2002 to December 2008. The collected data included demographic characteristics of the patients, mode of delivery, pre-existing medical conditions, reason for admission, specific intervention, length of stay and maternal outcome. A total of 43 women required admission to the intensive care unit (ICU), which represented 0.37% of all deliveries. The majority (95.3%) of patients were admitted to the ICU postpartum. The most common reasons for admissions were (pre)eclampsia (48.8%) and obstetric haemorrhage (37.2). The remainder included adult respiratory distress syndrome (6.9%), pulmonary embolism (2.3%) and neurological disorders (4.6%). Mechanical ventilation was required to support 18.6% of patients and transfusion of red blood cells was needed for 48.8% of patients. There were three maternal deaths (6.9%). A multidisciplinary team approach is essential to improve the management of hypertensive disorders and postpartum haemorrhage to achieve significant improvements in maternal outcome. A large, prospective study to know which women are at high risk of admission to the intensive care units and to prevent serious maternal morbidity and mortality is warranted.

摘要

这项回顾性研究的目的是调查2002年1月至2008年12月期间入住约旦阿卜杜拉国王大学医院多学科重症监护病房的孕妇及刚分娩妇女的收治指征、干预措施及临床结局。收集的数据包括患者的人口统计学特征、分娩方式、既往病史、入院原因、具体干预措施、住院时间及产妇结局。共有43名妇女需要入住重症监护病房(ICU),占所有分娩人数的0.37%。大多数患者(95.3%)在产后入住ICU。入院最常见的原因是子痫前期(48.8%)和产科出血(37.2%)。其余原因包括成人呼吸窘迫综合征(6.9%)、肺栓塞(2.3%)和神经系统疾病(4.6%)。18.6%的患者需要机械通气支持,48.8%的患者需要输注红细胞。有3例产妇死亡(6.9%)。多学科团队方法对于改善高血压疾病和产后出血的管理以显著改善产妇结局至关重要。有必要开展一项大型前瞻性研究,以了解哪些妇女有入住重症监护病房的高风险,并预防严重的孕产妇发病和死亡。

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