A prospective observational study of demographic profile and maternal and neonatal outcomes in emergency obstetrics
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20252744Keywords:
Antenatal care, Maternal morbidity, Neonatal outcome, Obstetric ICU, PreeclampsiaAbstract
Background: Emergency obstetric care (EmOC) is vital in reducing maternal and neonatal morbidity and mortality. Tertiary care centers serve as critical hubs for managing high-risk pregnancies and obstetric complications. Objectives were to evaluate the clinical profile, maternal morbidity, and neonatal outcomes of obstetric ICU admissions at a tertiary care center and assess associations with booking status and ICU stay duration.
Methods: A prospective observational study was conducted at Al-Ameen Medical College Hospital, Karnataka, from July 2023 to January 2025. A total of 160 obstetric ICU patients meeting inclusion criteria were enrolled. Data on age, booking status, ICU diagnosis, length of stay, delivery mode, maternal morbidity, and NICU admissions were collected and analyzed using SPSS v23. Statistical significance was set at p<0.05.
Results: Most patients were aged 31-40 years (43.8%) and unbooked (75%). Preeclampsia (25%), severe anemia (13.8%), and sepsis (12.5%) were the leading ICU admission causes. Maternal morbidity was significantly higher in unbooked patients (p=0.03). NICU admissions (27.5%) were significantly associated with ICU stay >7 days (p=0.001).
Conclusions: Unbooked status and preventable complications are major contributors to ICU admissions. Strengthening antenatal services and improving referral systems are essential for better maternal and neonatal outcomes.
Metrics
References
Rathore M, Upadhyay S. Retrospective analysis of obstetrical emergencies at a tertiary care centre in southern Rajasthan and associated maternal and perinatal outcome. Int J Clin Obstet Gynaecol. 2023;7(6):1-6. DOI: https://doi.org/10.33545/gynae.2023.v7.i6a.1391
Sarkar S, Ghai A, Manghat S, Venkatesh Y, Chaturvedula L. Outcome of emergency obstetric cases in relation to the referral pattern at a tertiary hospital in Puducherry: a cross-sectional descriptive study. Indian J Public Health. 2023;67(3):221-5. DOI: https://doi.org/10.4103/ijph.ijph_1124_22
Vandhana PM, Zahir F, Das DN, Deori RK. Fetomaternal outcome of referred obstetric patients in a tertiary centre in North East India: a cross-sectional study. J Clin Diagn Res. 2023;17(5):QC01-6. DOI: https://doi.org/10.7860/JCDR/2023/64050.18571
Badal S, Singh L. Maternal outcome of term obstetric emergencies referred to tertiary care centre. Int J Reprod Contracept Obstet Gynecol. 2021;10(6):2384-8. DOI: https://doi.org/10.18203/2320-1770.ijrcog20212678
Rathod AD, Pajai SP. Emergency obstetric hysterectomies at a tertiary referral Shri Vasantrao Naik Government Medical College and Hospital of tribal Yavatmal district (Maharashtra): retrospective critical analysis (6 years study). J South Asian Feder Obstet Gynecol. 2015;7(2):55-60. DOI: https://doi.org/10.5005/jp-journals-10006-1323
Ghosh A, Mandal S, Gharami S, Show P. Fetomaternal outcomes of emergency obstetric hysterectomy in a tertiary care teaching hospital in eastern India: A prospective study. Indian J Obstet Gynecol Res. 2022;9(4):563-7. DOI: https://doi.org/10.18231/j.ijogr.2022.101
Chidambaram S, Rangasamy P, Velu M, Ramarajan R, Suresh S. Clinical presentation and outcome of emergency obstetric hysterectomy in a rural tertiary care centre: A case series. Thiruvarur Med Coll J. 2023;15(2):45-9.
Mehta K, Govani K, Jogia A, Aparnathi R, Lodhiya K, Kotadiya S. A retrospective record-based study to identify the indications and outcomes of obstetric referrals to a tertiary care centre in Gujarat, India. Nat J Community Med. 2024;15(1):25-30. DOI: https://doi.org/10.55489/njcm.150120243458
Karuna G, Rao BS, Himabindhu P, Karunavathi G. Retrospective study of maternal outcome in obstetric emergencies at tertiary care hospital GGH, Vijayawada, South India. J Obstet Emerg Care. 2022;12(2):35-40.
Aggarwal N, Singla R, Dhaliwal L, Suri V. Audit of emergency obstetric referrals: a pilot study from tertiary care centre of North India. Bangladesh J Obstet Gynecol. 2016;30(1):25-9. DOI: https://doi.org/10.3329/bjog.v30i1.30504
Benson AE, Martens KL, Ryan KS, Lo JO, Garg B, Chobrutskiy B, et al. Correction of anemia with intravenous iron mitigates adverse maternal outcomes in pregnancy. Blood. 2023;142(6):1299-310. DOI: https://doi.org/10.1182/blood-2023-178359
Surovi FA, Noor S, Ali SM, Sultana A. Maternal near miss in a tertiary care hospital: An observational study. Chatt Maa Shi Hosp Med Coll J. 2022;21(1):57-60. DOI: https://doi.org/10.3329/cmoshmcj.v21i1.59762
Harrison R, Lauhon S, Colvin Z, McIntosh J. Maternal anemia and severe maternal morbidity in a United States cohort. Am J Obstet Gynecol MFM. 2021;3(3):100395. DOI: https://doi.org/10.1016/j.ajogmf.2021.100395
Iordache M, Meca D, Cirstoiu M. SARS-CoV-2 infection in pregnant women with hypothyroidism. Cureus. 2024;16(4):61206. DOI: https://doi.org/10.7759/cureus.61206
Jariwala SZ, Jain M. A retrospective analytical study on causes and contributory factors of maternal mortality. Int J Reprod Contracept Obstet Gynecol. 2024;13(3):456-62. DOI: https://doi.org/10.18203/2320-1770.ijrcog20243165
Krawczyk P, Dabrowska D, Guasch E, Jörnvall H, Lucas N, Mercier FJ, et al. Preparedness for severe maternal morbidity in European hospitals: The MaCriCare study. Anesth Crit Care Pain Med. 2024;24(1):101355. DOI: https://doi.org/10.1016/j.accpm.2024.101355
Pérez A, Bacallao J, Alcina S, Gómez Y. Severe maternal morbidity in the intensive care unit of a Havana teaching hospital, 1998 to 2004. MEDICC Rev. 2008;10(3):17-23. DOI: https://doi.org/10.37757/MR2008.V10.N3.7
Singh N, Sreedevi S, Sushma. Observational study of maternal and fetal outcomes in obstetric emergencies admitted to a tertiary care centre. Int J Reprod Contracept Obstet Gynecol. 2020;9(6):4799.
Yadav G, Sharma C, Singh P, Solanki V, Chhabra S, Kathuria P, et al. Incidence, causes, and perinatal outcomes of “near-miss” obstetric emergencies during the COVID-19 pandemic: Experience from a tertiary referral center of Western Rajasthan, India. Indian J Community Med. 2024;49(1):1-8. DOI: https://doi.org/10.4103/ijcm.ijcm_552_23
Mousa A, Mandili RL, Aljahdali M, Gari S, Khaimi S, Alahdal S, et al. Maternal and fetal outcomes of preeclampsia with and without severe features in King Abdulaziz University Hospital, Jeddah, Saudi Arabia: a retrospective study. Cureus. 2022;14(7):31013. DOI: https://doi.org/10.7759/cureus.31013