Publication:

A study of clinical characteristics and outcome of obstetric patients in intensive care and high dependency unit of a tertiary centre of Jharkhand, India

Background Few women during their pregnancy, labour and postnatal period require critical care related to the pregnancy itself, aggravation of a pre-existing illness and complications of the delivery. Pregnant patients account for a small number of ICU admission - 2-10% two main indications for admission are hypertensive disorders (17.2%-46%) and massive haemorrhage (10%-32.8%). The primary objective of the present study was to review the characteristics of the obstetric patients admitted to our ICU over a 2-year period.

Methods It was a prospective study conducted over 50 patients in high dependency and intensive care unit at Alam hospital over a period of 2 years (October 2014 to October 2016).

Results During the study period a total of 50 obstetric patients were transferred to the intensive care unit (ICU). Antenatal care played significant role in the obstetric outcome. 84% of patients transferred to the ICU during the study period had inadequate or no antenatal care, while 8% were booked in their pregnancy and had adequate antenatal care. ICU interventions included mechanical ventilation used in 20(40%) patients, blood and blood product transfusion in 35(70%) patients’ inotropes in 20 patients (40%) antihypertensive therapy in 20 patients (40%), arterial embolization in 2(4%) patients. Maternal mortality was seen in 10 patients (20%).

Conclusions There is a need for training in emergency obstetrics so that the complication can be managed right at the time of occurrence.