De Greve Morgan, Van Mieghem Tim, Van Den Berghe Greet, Hanssens Myriam
Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium.
Gynecol Obstet Invest. 2016;81(4):315-20. doi: 10.1159/000431224. Epub 2016 Mar 11.
A better understanding of the characteristics of obstetric patients admitted to an intensive care unit (ICU) could guide where the focus of obstetric training and awareness should be directed at to reduce further maternal mortality and morbidity.
We retrospectively assessed the charts of all women admitted during pregnancy or postpartum to a tertiary ICU over a 12-year period. We retrieved whether women were followed locally or referred from another hospital and whether the ICU admission was prophylactic or therapeutic.
There were 190 admissions in 183 women. One-hundred and four admissions were in referred women and 86 in women cared for locally. Seventy-eight admissions (41.1%) were for direct obstetric causes (primarily postpartum hemorrhage (n = 14), hypertensive disorders of pregnancy (n = 12) and peripartum cardiomyopathy (n = 10)). Indirect obstetric admissions (n = 89; 46.8%) were primarily for cardiopathies (n = 35) and pulmonary diseases (n = 18). Among non-obstetric admissions, trauma (n = 6; 26.1%) and neurologic tumors (n = 6; 26.1%) were the most common.
Pre-existing and acquired cardiopathies are the main reason for admission to an ICU in a developed country and have surpassed hypertensive disorders and hemorrhage. This should become a focus of obstetric care provider training.
更好地了解入住重症监护病房（ICU）的产科患者的特征，可为产科培训和认知的重点方向提供指导，以进一步降低孕产妇死亡率和发病率。
我们回顾性评估了12年间所有在孕期或产后入住三级ICU的女性患者的病历。我们了解了这些女性是在当地接受治疗还是从其他医院转诊而来，以及入住ICU是预防性的还是治疗性的。
183名女性患者共190次入院。104次入院是转诊患者，86次入院是当地接受治疗的患者。78次入院（41.1%）是直接产科原因（主要是产后出血（n = 14）、妊娠高血压疾病（n = 12）和围产期心肌病（n = 10））。间接产科入院（n = 89；46.8%）主要是心脏病（n = 35）和肺部疾病（n = 18）。在非产科入院患者中，创伤（n = 6；26.1%）和神经肿瘤（n = 6；26.1%）最为常见。
在发达国家，既往存在的和后天获得的心脏病是入住ICU的主要原因，已超过高血压疾病和出血。这应成为产科护理人员培训的重点。
