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Research paper
Published online: 2021-04-08
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Pregnancy related and postpartum admissions to intensive care unit in the obstetric tertiary care center — an 8-year retrospective study

Pawel Krawczyk, Agnieszka Jastrzebska, Daniel Lipka, Hubert Huras
DOI: 10.5603/GP.a2021.0034
·
Pubmed: 33844261

open access

Ahead of Print
ORIGINAL PAPERS Obstetrics
Published online: 2021-04-08

Abstract

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.

Abstract

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.

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Keywords

maternal morbidity; maternal mortality; maternal critical care; intensive care unit

About this article
Title

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

Journal

Ginekologia Polska

Issue

Ahead of Print

Article type

Research paper

Published online

2021-04-08

DOI

10.5603/GP.a2021.0034

Pubmed

33844261

Keywords

maternal morbidity
maternal mortality
maternal critical care
intensive care unit

Authors

Pawel Krawczyk
Agnieszka Jastrzebska
Daniel Lipka
Hubert Huras

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