SPECTRUM AND OUTCOMES IN OBSTETRIC PATIENTS ADMITTED TO INTENSIVE CARE UNIT IN A TERTIARY CARE HOSPITAL

Background: Obstetric patients are a special group as both maternal and fetal wellbeing needs to be taken care of. There is increasing evidence that admission of high‑risk patients in Intensive Care Unit (ICU) is associated with reduction in maternal mortality.The present study aims to analyze the demographics, indications, clinical profile, management, and outcomes of obstetric patients requiring admission to the intensive care unit of a tertiary level hospital.

Methods: This is a prospective observational study of all obstetric patients admitted to a multidisciplinary ICU of a tertiary care hospital (King George Hospital) over a period of 2 years (January2020 – December 2021). Data was analyzed using the SSP software, a statistical analysis tool widely used for managing and interpreting clinical data.

Results: A total of 100 patients admitted to ICU during the study period were included in the study. Majority of the patients were under 30 years of age, primiparous, and unbooked. The common obstetric indications for ICU admission were pre eclampsia & eclampsia, obstetric hemorrhage, septicemia, rupture uterus, and obstructed labor medical indications were anemia & epilepsy. The maternal and perinatal mortality was 34% and 30.5%, respectively. Maternal unbooked status was significantly associated with maternal mortality (P < 0.05).

Conclusions: Ensuring that all antenatal cases are booked, early detection of risk factors, referral to tertiary care centers at the appropriate time go a long way in reducing the maternal mortality and morbidity. Further prospective studies will help in formulating evidence based guidelines for the management of critically ill obstetric patients.