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Obstetric admissions to the intensive care unit
N G Mahutte1, L Murphy-Kaulbeck, Q Le
1Department of Obstetrics and Gynecology, the Royal Victoria General Hospital, McGill University, Montreal, Quebec, Canada. nmahut1@po-box.mcgill.ca
Obstetrics and Gynecology
|August 4, 1999
Summary
Obstetric intensive care unit (ICU) admissions, primarily for hemorrhage and hypertension, can indicate quality of care. Strategies to manage these conditions may reduce maternal morbidity.
Area of Science:
- Obstetrics and Gynecology
- Critical Care Medicine
- Healthcare Quality Improvement
Background:
- Obstetric intensive care unit (ICU) admissions are infrequent, representing 0.3% of deliveries.
- The majority of obstetric ICU admissions occur postpartum.
Purpose of the Study:
- To evaluate the utility of obstetric intensive care unit (ICU) admissions as quality-assurance indicators.
- To identify common reasons for obstetric ICU admissions.
Main Methods:
- Retrospective analysis of obstetric ICU admissions at two tertiary care centers.
- Data collected from 1991 to 1997.
Main Results:
- Obstetric hemorrhage (26%) and hypertension (21%) were the leading causes for ICU admission.
- Preexisting conditions were noted in 38% of patients; the median Acute Physiology and Chronic Health Evaluation II score was 8.5.
- The actual mortality rate (2.3%) was significantly lower than the predicted rate (10.0%).
Conclusions:
- Obstetric hemorrhage and uncontrolled hypertension are key factors leading to ICU admission.
- Enhancing management strategies for obstetric hemorrhage and hypertension could substantially decrease maternal morbidity.