Obstetric admissions to the intensive therapy unit of a tertiary care institution

Between 0.1% and 0.9% of women develop pregnancy complications which require admission to an intensive therapy unit. The aim of this study was to review all obstetric admissions to the intensive therapy unit at the KK Women's and Children's Hospital from 1998 to 1999 with respect to indications for admission, interventions employed and clinical outcome.

The medical records of all obstetric patients admitted to the intensive therapy unit during the 2-year period were analysed retrospectively. Subjects were included if they were admitted during pregnancy up to 42 days postpartum.

There were 31,725 deliveries in our hospital during the study period of which there were 239 admissions to the intensive therapy unit. Of these, 42% were Malays, 41% Chinese, 12% Indians and 5% other races. 65% stayed 1 day, 24% 2 days, 7% 3 days and 4% more than 3 days. The patients' ages ranged from 18 to 44 years. The indications for admission were hypertension (50%), haemorrhage (24%), respiratory insufficiency (10%), neurological problems (11%) and sepsis (3%). Intervention-wise, 43% of patients required vasoactive infusions, 35% had arterial line placement, 22% central venous pressure monitoring, 21% ventilatory support and 2% pulmonary artery catheter placement. The maternal mortality and stillbirth rates were 1.3% and 3.7% of intensive therapy unit admissions, respectively.

The admission rate to the intensive therapy unit in our institution was 0.73% of all deliveries during the 2-year study period. Hypertensive disease and haemorrhage were the predominant admitting diagnoses.