Farr Alex, Lenz-Gebhart Agnes, Einig Sabrina, Ortner Clemens, Holzer Iris, Elhenicky Marie, Husslein Peter W, Lehner Rainer
Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Department of Anesthesia, General Intensive Care Medicine and Pain Therapy, Medical University of Vienna, Vienna, Austria.
Wien Klin Wochenschr. 2017 Sep;129(17-18):605-611. doi: 10.1007/s00508-016-1161-z. Epub 2017 Jan 18.
The number of pregnant women with severe comorbidities is increasing. The aim of the present study was to analyze outcomes and determine trends in women who required peripartum admission to the intensive care unit (ICU).
In this retrospective study, we identified all women who were admitted to the ICU between the second trimester of pregnancy and 6 weeks postpartum. Women with ICU admission between 2011 and 2014 were assigned to the study group, whereas those admitted between 1996 and 2003 were assigned to the historical group. Comorbidities, characteristics, outcomes, and treatment efforts were assessed. Descriptive analysis, Fisher's exact test, unpaired Student's t-test and one-way ANOVA were performed.
We identified 238 cases, including 135 (56.7%) in the study group and 103 (43.3%) in the historical group. In 83 (34.9%) women, deterioration of the pre-existing medical condition was causal for ICU admission. Overall, preterm delivery and mean gestational age were 81.5% and 31.6 ± 6.2 weeks, respectively. In comparison to the historical group, women of the study group were older (p = 0.005), more frequently presented with multiple comorbidities (p = 0.003), pre-existing conditions (p < 0.001), and congenital heart disease (p = 0.012). Moreover, they had a shorter length of stay at the ICU than those of the historical group (p = 0.02).
Peripartum ICU admissions are increasing in frequency. As maternal characteristics are changing, adequate risk stratification with multidisciplinary care are essential, and access to intermediate care units would be preferable for patients with short-term admission.
患有严重合并症的孕妇数量正在增加。本研究的目的是分析结局，并确定需要在围产期入住重症监护病房（ICU）的女性的趋势。
在这项回顾性研究中，我们确定了所有在妊娠中期至产后6周期间入住ICU的女性。2011年至2014年期间入住ICU的女性被分配到研究组，而1996年至2003年期间入住的女性被分配到历史组。评估合并症、特征、结局和治疗措施。进行描述性分析、Fisher精确检验、非配对学生t检验和单因素方差分析。
我们确定了238例病例，其中研究组135例（56.7%），历史组103例（43.3%）。在83例（34.9%）女性中，原有疾病的恶化是入住ICU的原因。总体而言，早产率和平均孕周分别为81.5%和31.6±6.2周。与历史组相比，研究组女性年龄更大（p = 0.005），更频繁地出现多种合并症（p = 0.003）、原有疾病（p < 0.００１）和先天性心脏病（p = 0.012）。此外，她们在ICU的住院时间比历史组短（p = 0.02）。
围产期入住ICU的频率正在增加。由于孕产妇特征在变化，进行充分的风险分层并提供多学科护理至关重要，对于短期入住的患者，进入中间护理单元可能更好。
