Clinical characteristics and outcomes of obstetric patients admitted to the intensive care unit. 2012

Fernando G Rios, and Alejandro Risso-Vázquez, and Javier Alvarez, and Mauricio Vinzio, and Pablo Falbo, and Natalia Rondinelli, and Dario H Bienzobas
Hospital Nacional Profesor Alejandro Posadas, Buenos Aires, Argentina. fernandrios@gmail.com

OBJECTIVE To identify the reasons for admitting pregnant women to intensive care units (ICUs) in Buenos Aires, Argentina. METHODS The admission diagnoses of pregnant women hospitalized over 2 years at 4 ICUs were retrospectively studied. RESULTS During the studied period, 242 (3.9%) of the 6271 ICU patients were pregnant women, for an incidence of 8.1 per 1000 deliveries. The main reasons for admitting them at ICUs were hypertensive disorders, followed by postpartum hemorrhage and sepsis. More than a third (39.7%) was in a first pregnancy. The main nonobstetric reason for admission was pneumonia. The median pregnancy duration on admission was 36 weeks (range, 33-38 weeks) but it was less than 34 weeks for 66 (27.2%) of the women, 12.4% on whom required ventilation. Mortality was highest among those admitted for nonobstetric reasons (13.3% vs 0.5%; P<0.05). The median stay for obstetric or nonobstetric conditions was 2 versus 5 days (range, 2-3 days vs 2-8 days) (P<0.001). CONCLUSIONS Postpartum hemorrhage and hypertensive disorders were the most common reasons for admitting pregnant women to an ICU, followed by sepsis. Nonobstetric causes of admission were associated with higher morbidity and mortality rates.

UI MeSH Term Description Entries
D007362 Intensive Care Units Hospital units providing continuous surveillance and care to acutely ill patients. ICU Intensive Care Units,Intensive Care Unit,Unit, Intensive Care
D007902 Length of Stay The period of confinement of a patient to a hospital or other health facility. Hospital Stay,Hospital Stays,Stay Length,Stay Lengths,Stay, Hospital,Stays, Hospital
D008428 Maternal Mortality Maternal deaths resulting from complications of pregnancy and childbirth in a given population. Mortality, Maternal,Maternal Mortalities,Mortalities, Maternal
D011014 Pneumonia Infection of the lung often accompanied by inflammation. Experimental Lung Inflammation,Lobar Pneumonia,Lung Inflammation,Pneumonia, Lobar,Pneumonitis,Pulmonary Inflammation,Experimental Lung Inflammations,Inflammation, Experimental Lung,Inflammation, Lung,Inflammation, Pulmonary,Inflammations, Lung,Inflammations, Pulmonary,Lobar Pneumonias,Lung Inflammation, Experimental,Lung Inflammations,Lung Inflammations, Experimental,Pneumonias,Pneumonias, Lobar,Pneumonitides,Pulmonary Inflammations
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D011248 Pregnancy Complications Conditions or pathological processes associated with pregnancy. They can occur during or after pregnancy, and range from minor discomforts to serious diseases that require medical interventions. They include diseases in pregnant females, and pregnancies in females with diseases. Adverse Birth Outcomes,Complications, Pregnancy,Adverse Birth Outcome,Birth Outcome, Adverse,Complication, Pregnancy,Outcome, Adverse Birth,Pregnancy Complication
D005260 Female Females
D006473 Postpartum Hemorrhage Excess blood loss from uterine bleeding associated with OBSTETRIC LABOR or CHILDBIRTH. It is defined as blood loss greater than 500 ml or of the amount that adversely affects the maternal physiology, such as BLOOD PRESSURE and HEMATOCRIT. Postpartum hemorrhage is divided into two categories, immediate (within first 24 hours after birth) or delayed (after 24 hours postpartum). Hemorrhage, Postpartum,Delayed Postpartum Hemorrhage,Immediate Postpartum Hemorrhage,Hemorrhage, Delayed Postpartum,Hemorrhage, Immediate Postpartum,Postpartum Hemorrhage, Delayed,Postpartum Hemorrhage, Immediate
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths

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