The role of a high-dependency unit in a regional obstetric hospital

The aim of our study was to review a series of critically ill patients admitted to a high-dependency unit (HDU) in a regional obstetric centre, to assess our HDU utilisation rate and to determine the indications for and rate of transfer to an intensive care unit (ICU) in a tertiary referral centre. A 4-year retrospective review of case notes and HDU/ICU registers was performed. One hundred and twenty-three patients were admitted to the HDU in the 2 years following its inception, representing 1.02% of all deliveries. Obstetric complications accounted for 81.3% of admissions. Seventeen patients were admitted to an ICU during the study period; 12 (0.08%) were transferred before and five (0.04%) after the development of HDU facilities (p = 0.25). The advantages of a HDU within this setting include the concurrent availability of expert obstetric care and critical care management, the avoidance of the hazards of emergency transport and improved continuity of antenatal and postnatal care.