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产科患者入住重症监护病房的临床特征和结局。

Clinical characteristics and outcomes of obstetric patients admitted to the intensive care unit.

机构信息

Hospital Nacional Profesor Alejandro Posadas, Buenos Aires, Argentina.

出版信息

Int J Gynaecol Obstet. 2012 Nov;119(2):136-40. doi: 10.1016/j.ijgo.2012.05.039. Epub 2012 Aug 16.

Abstract

OBJECTIVE

To identify the reasons for admitting pregnant women to intensive care units (ICUs) in Buenos Aires, Argentina.

METHODS

The admission diagnoses of pregnant women hospitalized over 2 years at 4 ICUs were retrospectively studied.

RESULTS

During the studied period, 242 (3.9%) of the 6271 ICU patients were pregnant women, for an incidence of 8.1 per 1000 deliveries. The main reasons for admitting them at ICUs were hypertensive disorders, followed by postpartum hemorrhage and sepsis. More than a third (39.7%) was in a first pregnancy. The main nonobstetric reason for admission was pneumonia. The median pregnancy duration on admission was 36 weeks (range, 33-38 weeks) but it was less than 34 weeks for 66 (27.2%) of the women, 12.4% on whom required ventilation. Mortality was highest among those admitted for nonobstetric reasons (13.3% vs 0.5%; P<0.05). The median stay for obstetric or nonobstetric conditions was 2 versus 5 days (range, 2-3 days vs 2-8 days) (P<0.001).

CONCLUSION

Postpartum hemorrhage and hypertensive disorders were the most common reasons for admitting pregnant women to an ICU, followed by sepsis. Nonobstetric causes of admission were associated with higher morbidity and mortality rates.

摘要

目的

确定阿根廷布宜诺斯艾利斯重症监护病房(ICU)收治孕妇的原因。

方法

回顾性研究了 4 家 ICU 住院超过 2 年的孕妇入院诊断。

结果

在所研究期间,6271 名 ICU 患者中有 242 名(3.9%)为孕妇,发生率为每 1000 例分娩 8.1 例。将她们收治 ICU 的主要原因是高血压疾病,其次是产后出血和败血症。超过三分之一(39.7%)为初产妇。主要的非产科入院原因是肺炎。入院时的中位妊娠时间为 36 周(范围为 33-38 周),但有 66 名(27.2%)孕妇的妊娠时间不足 34 周,其中 12.4%需要通气。因非产科原因入院的患者死亡率最高(13.3%比 0.5%;P<0.05)。产科和非产科情况的中位住院时间分别为 2 天和 5 天(范围分别为 2-3 天和 2-8 天)(P<0.001)。

结论

产后出血和高血压疾病是孕妇入住 ICU 的最常见原因,其次是败血症。非产科入院原因与较高的发病率和死亡率相关。

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