Improving pregnancy outcomes in tertiary care institution in India through obstetric intensive care unit: three-year analysis

Ashish V. Gokhale; Shonali Agarwal; Dimpi Modi

doi:10.18203/2320-1770.ijrcog20201789

Authors

Ashish V. Gokhale Department of Obstetrics and Gynecology, S. S. G. Hospital, Vadodara, Gujarat, India
Shonali Agarwal Department of Obstetrics and Gynecology, S. S. G. Hospital, Vadodara, Gujarat, India
Dimpi Modi Department of Obstetrics and Gynecology, S. S. G. Hospital, Vadodara, Gujarat, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20201789

Keywords:

High dependency unit, Intensive care unit, Obstetric critical care, Pregnancy complications

Abstract

Background: To analyse the requirement of high dependency unit (HDU)/intensive care unit (ICU) in an obstetric population in terms of utilization rate, indications for admission, interventions required and gestational outcome.

Methods: Retrospective observational study was carried out from April 2015 to September 2018 at department of obstetrics and gynecology SSG Hospital, Vadodara India. Data related to indications for ICU admission, interventions required, length of stay and outcomes were collected, and results were analyzed.

Results: Obstetric ICU utilization rate was 130 per 1000 deliveries. The major obstetric indications for admission were hypertensive disorders of pregnancy (42%) followed by anemia (25%) and post-partum hemorrhage (3%). In the rest of the patient’s majority (50%) had cardiovascular problems. Maternal mortality among these critically ill women was 3.76%. The death rate in the present study was high among patients admitted for non-obstetric (74.54%) as opposed to obstetric indications (25.46%).

Conclusions: Establishment of well managed high dependency and intensive care unit in health care facilities dealing with high volumes of high-risk maternity cases reduces the maternal mortality significantly and results in improved maternal outcomes.

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References

Leung NY, Lau AC, Chan KK, Yan WW. Clinical characteristics and outcomes of obstetric patients admitted to the Intensive Care Unit: a 10-year retrospective review. Hong Kong Med J. 2010;16(1):18-25.

Ryan M, Hamilton V, Bowen M, McKenna P. The role of a high‐dependency unit in a regional obstetric hospital. Anaesth. 2000;55(12):1155-8.

Karnad DR, Lapsia V, Krishnan A, Salvi VS. Prognostic factors in obstetric patients admitted to an Indian intensive care unit. Critical Care Med. 2004;32(6):1294-9.

Zwart JJ, Dupuis JR, Richters A, Öry F, van Roosmalen J. Obstetric intensive care unit admission: a 2-year nationwide population-based cohort study. Intens Care Med. 2010;36(2):256-63.

Pollock W, Rose L, Dennis CL. Pregnant and postpartum admissions to the intensive care unit: a systematic review. Intens Care Med. 2010;36(9):1465-74.

Collop NA, Sahn SA. Critical illness in pregnancy: An analysis of 20 patients admitted to a medical intensive care unit. Chest. 1993;103(5):1548-52.

Platteau P, Engelhardt T, Moodley J, Muckart DJJ. Obstetric gynaecological patients in an intensive care unit: a 1 year review. Trop Doctor. 1997:202-6.

Ridley SA. Intermediate care possibilities, requirements and solutions. Anaesth. 1998;53(7):654-64.

Dattaray C, Mandal D, Shankar U, Bhattacharya P, Mandal S. Obstetric patients requiring high-dependency unit admission in a tertiary referral centre. Inte J Critic Ill Inj Sci. 2013;3(1):31.

Bhat PB, Navada MH, Rao SV, Nagarathna G. Evaluation of obstetric admissions to intensive care unit of a tertiary referral center in coastal India. Indian J Crit Care Med. 2013;17(1):34.

Chalkley S. Acute illness essentials Care of the Acutely Ill Adult: An Essential Guide for Nurses Fiona Creed and Christine Spiers ISBN: 9780199564385 Oxford University Press 2010, £27.95. Br J Card Nurs. 2011:480.