Pregnancy related and postpartum admissions to intensive care unit in the obstetric tertiary care center - an 8-year retrospective study.

OBJECTIVES

The purpose of the study was to analyze the incidence of maternal morbidity and mortality of pregnant and postpartum women admitted to the intensive care unit (ICU).

MATERIAL AND METHODS

Retrospective analysis of all pregnant and postpartum patients admitted to ICU of the obstetric tertiary care center between January 1, 2007 and December 31, 2014.

RESULTS

A total of 266 patients with pregnancy and postpartum related morbidity were admitted to ICU (12.56 per 1000 deliveries). It accounted for 21.08% of all adult admissions of the unit. Mean age was 30.2 ± 5.6 years, mean gestational age was 30.8 ± 7.6 weeks. Two hundred forty patients (90.23%) were primiparous, 17 (6.4%) were twin pregnancy. Main reasons of admission included hypertensive disorders of pregnancy n = 99 (37.22%; 4.68 per 1000 deliveries), hemorrhage n = 46 (17.29%; 2.17 per 1000 deliveries) and sepsis/infection n = 46 (17.29%; 2.17 per 1000 deliveries). Median length of stay was five days (IQR 4-7). Artificial ventilation was required in 91 patients (34.21%), 147 (55.26%) required vasoactive drugs, 33 (12.41%) had metabolic disturbances, 21 (7.89%) required total parenteral nutrition and 4 (1.50%) renal replacement therapy. We report four maternal deaths (1.5%; 0.19 per 1000 deliveries).

CONCLUSIONS

There are three main reasons of obstetric ICU admissions: hypertensive disorders of pregnancy, obstetric hemorrhage and sepsis/infection. The majority of obstetric patients admitted to ICU did not require multi-organ supportive therapy. Availability of intermediate care facility could reduce unnecessary admission to ICU.