Lelong E, Pourrat O, Pinsard M, Goudet V, Badin J, Mimoz O, Pierre F
Service de gynécologie obstétrique, université de Poitiers, CHU de Poitiers, Poitiers, France.
Rev Med Interne. 2013 Mar;34(3):141-7. doi: 10.1016/j.revmed.2012.10.007. Epub 2013 Feb 13.
Very few studies had been published about admission of obstetric patients in French intensive care units (ICU).
Files of women who had been admitted during pregnancy or the postpartum period to ICU of an academic hospital between January 1st 1997 and 31st December 2006 were analyzed. Diagnosis at admission, severity, main treatments and outcome were studied during two successive periods of 5 years.
There were 96 admissions (0.95% of all admissions to ICU). They included 34 complications due to arterial hypertension (35%), among them 10 cases of pre-eclampsia, eight of eclampsia, seven of Hemolysis-Liver Enzymes-Low Platelet (HELLP) syndrome and two of retroplacental hematoma ; 26 postpartum haemorrhages (27%); and 36 miscellaneous diagnosis including two sepsis, four acute pulmonary oedema, four cardiomyopathy, three pulmonary embolism, and three acute liver steatosis. Mean Simplified Acute Physiologic Score (SAPS II) was 18.5±11.2 and mean Sequential Organ Failure Assessment (SOFA) 2.1±2.3. The main treatments were mechanical ventilation (50% of all cases) and transfusion (32%). The average ICU stay was 5.7±5.4 days. Two maternal deaths were observed (aortic dissection and peripartum cardiomyopathy). The number of patients admitted for postpartum haemorrhage increased from five to 21 over the two successive periods of the study.
The number of women admitted to ICU during pregnancy or the postpartum period is low. Admissions for hemorrhage have increased. Regular monitoring of maternal morbidity and mortality gives relevant clues for assessing the quality of obstetrical care.
关于法国重症监护病房（ICU）收治产科患者的研究发表极少。
分析了1997年1月1日至2006年12月31日期间在一所教学医院ICU住院的孕期或产后女性的病历。在两个连续的5年期间，研究了入院诊断、严重程度、主要治疗方法及结局。
共收治96例患者（占ICU所有收治患者的0.95%）。其中包括34例因动脉高血压导致的并发症（35%），其中10例为子痫前期，8例为子痫，7例为溶血-肝酶-血小板减少（HELLP）综合征，2例为胎盘后血肿；26例产后出血（27%）；以及36例其他诊断，包括2例败血症、4例急性肺水肿、4例心肌病、3例肺栓塞和3例急性肝脂肪变性。简化急性生理学评分（SAPS II）平均为18.5±11.2，序贯器官衰竭评估（SOFA）平均为2.1±2.3。主要治疗方法为机械通气（占所有病例的50%）和输血（32%）。ICU平均住院时间为5.7±5.4天。观察到2例孕产妇死亡（主动脉夹层和围产期心肌病）。在研究的两个连续期间，因产后出血入院的患者数量从5例增加到21例。
孕期或产后入住ICU的女性数量较少。出血相关的收治病例有所增加。定期监测孕产妇发病率和死亡率可为评估产科护理质量提供相关线索。
