From the Department of Anesthesiology and Intensive Care, Istanbul Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.
From the Department of Gynecology and Obstetrics, Istanbul Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.
Ann Saudi Med. 2023 Jan-Feb;43(1):10-16. doi: 10.5144/0256-4947.2023.10. Epub 2023 Feb 2.
Although obstetric morbidity and mortality have decreased recently, rates are still high enough to constitute a significant health problem. With the COVID-19 pandemic, many obstetric patients have required treatment in intensive care units (ICU).
Evaluate critical obstetric patients who were treated in an ICU for COVID-19 and followed up for 90 days.
Medical record review SETTING: Intensıve care unit PATİENTS AND METHODS: Obstetric patients admitted to the ICU between 15 March 2020 and 15 March 2022 and followed up for at least 90 days were evaluated retrospectively. Patients with and without COVID-19 were compared by gestational week, indications, comorbidities, length of stay in the hospital and ICU, requirement for mechanical ventilation, blood transfusion, renal replacement therapy (RRT), plasmapheresis, ICU scores, and mortality.
Clinical outcomes and mortality.
102 patients with a mean (SD) maternal age of 29.1 (6.3) years, and median (IQR) length of gestation of 35.0 (7.8) weeks.
About 30% (n=31) of the patients were positive for COVID-19. Most (87.2%) were cesarean deliveries; 4.9% vaginal (8.7% did not deliver). COVID-19, eclampsia/preeclampsia, and postpartum hemorrhage were the most common ICU indications. While the 28-day mortality was 19.3% (n=6) in the COVID-19 group, it was 1.4% (n=1) in the non-COVID-19 group (<.001). The gestational period was significantly shorter in the COVID-19 group (=.01) while the duration of stay in ICU (<.001) and mechanical ventilation (=.03), lactate (=.002), blood transfusions (=.001), plasmapheresis requirements (=.02), and 28-day mortality were significantly higher (<.001). APACHE-2 scores (=.007), duration of stay in ICU (<.001) and mechanical ventilation (<.001), RRT (=.007), and plasmapheresis requirements (=.005) were significantly higher in patients who died than in those who were discharged.
The most common indication for ICU admission was COVID-19. The APACHE-2 scoring was helpful in predicting mortality. We think multicenter studies with larger sample sizes are needed for COVID-19 obstetric patients. In addition to greater mortality and morbidity, the infection may affect newborn outcomes by causing premature birth.
Retrospectıve, single-center, small population size.
None.
尽管产科发病率和死亡率最近有所下降，但仍高得足以构成重大健康问题。随着 COVID-19 大流行，许多产科患者需要在重症监护病房 (ICU) 接受治疗。
评估在 ICU 因 COVID-19 接受治疗并随访 90 天的危急产科患者。
病历回顾
重症监护病房
回顾性评估 2020 年 3 月 15 日至 2022 年 3 月 15 日期间入住 ICU 的产科患者，随访至少 90 天。比较了 COVID-19 患者和非 COVID-19 患者的孕龄、指征、合并症、住院和 ICU 时间、机械通气、输血、肾脏替代治疗 (RRT)、血浆置换、ICU 评分和死亡率。
临床结果和死亡率。
102 例患者，平均（SD）年龄 29.1（6.3）岁，中位（IQR）妊娠 35.0（7.8）周。
约 30%（n=31）的患者 COVID-19 检测呈阳性。大多数（87.2%）为剖宫产；阴道分娩 4.9%（8.7%未分娩）。COVID-19、子痫/先兆子痫和产后出血是 ICU 最常见的指征。COVID-19 组 28 天死亡率为 19.3%（n=6），非 COVID-19 组为 1.4%（n=1）（<.001）。COVID-19 组的孕龄明显较短（=.01），而 ICU 入住时间（<.001）、机械通气（=.03）、乳酸（=.002）、输血（=.001）、血浆置换需求（=.02）和 28 天死亡率明显较高（<.001）。死亡患者的 APACHE-2 评分（=.007）、ICU 入住时间（<.001）和机械通气（<.001）、RRT（=.007）和血浆置换需求（=.005）明显高于出院患者。
ICU 入院的最常见指征是 COVID-19。APACHE-2 评分有助于预测死亡率。我们认为需要进行更大样本量的多中心研究。除了更高的死亡率和发病率外，感染还可能通过导致早产而影响新生儿结局。
回顾性、单中心、小样本量。
无。
