Obstetric admissions to the intensive care unit: an eight-year review

Between 0.1 and 0.9% of women develop complications of pregnancy that require admission to an intensive care unit (ICU). The purpose of this study was to review all obstetric patients admitted to the ICU over an 8-year period to determine the causes and outcomes of these admissions and the frequency and causes of maternal mortality.

This retrospective study was based on all obstetric patients admitted to the ICU at Hôtel-Dieu de France hospital (January 1998-December 2005). Data collected includes maternal age, gestational age, parity, past medical and obstetric history, delivery data, indication for ICU transfer, complications, ICU length of stay and death during hospitalization. Specific interventions were recorded.

A total of 15 patients were admitted during the 8 years. The frequency of admissions was 0.24% of deliveries and obstetric patients represented 0.43% of all ICU admissions. The mean duration of stay in ICU was 7 +/- 5 days. The indications for admissions were preeclampsia (26.7%), sepsis (26.7%), obstetric hemorrhage (20%), cerebral encephalopathy (6.65%), amniotic fluid embolism (133%) and preexisting medical problems (6.65%). Fourteen patients (93%) had invasive monitoring and 9 patients (60%) required ventilation. There were five deaths, representing 333% of obstetric ICU admissions.

The need for maternal intensive care should be one of the most important measure considered in the quality of maternal care. Early admission and management of critically ill obstetric patients in the ICU may decrease maternal mortality and morbidity.