Severe Maternal Morbidity Cases in Israel in a High-Volume High-Resource Referral Center: A Retrospective Cohort Study.
作者信息
Rottenstreich Misgav, Reznick Ortal, Sela Hen Y, Ioscovich Alexander, Grisaro Granovsky Sorina, Weiniger Carolyn F, Einav Sharon
机构信息
Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, affiliated with the Hebrew University Hadassah Medical School, Jerusalem, Israel.
Department of Pediatrics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
出版信息
Isr Med Assoc J. 2020 Mar;22(3):142-147.
BACKGROUND
Admission to an intensive care unit (ICU) is an objective marker of severe maternal morbidity (SMM).
OBJECTIVES
To determine the prevalence of obstetric ICU admissions in one medical center in Israel and to characterize this population.
METHODS
In this retrospective study the files of women coded for pregnancy, birth, or the perinatal period and admission to the ICU were pulled for data extraction (2005-2013).
RESULTS
During the study period, 111 women were admitted to the ICU among 120,279 women who delivered babies (0.09%). Their average age was 30 ± 6 years, most were multigravida, a few had undergone fertility treatments, and only 27% had complicated previous pregnancies. Most pregnancies (71.2%) were uneventful prior to admission. ICU admissions were divided equally between direct (usually hemorrhage) and indirect (usually cardiac disease) obstetric causes.
CONCLUSIONS
The indications for obstetrics ICU admission correlated with the proximate causes of maternal arrest observed worldwide. While obstetric hemorrhage is often unpredictable, deterioration of heart disease is foreseeable. Attention should be directed specifically toward improving the diagnosis and treatment of maternal heart disease during pregnancy in Israel.
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