Obstetric Intensive Care Admissions and Neonatal Outcomes: 15 Years of Experience from a Single Center

Background and Objectives: Maternal severe morbidity and mortality are measures for assessing maternal healthcare, and admissions to the intensive care unit (ICU) can be used to study these metrics. Here, we analyze ICU admissions of pregnant or postpartum women in a tertiary hospital. Materials and Methods: This is a retrospective, single-center, observational cohort study of obstetric intensive care admissions at a Portuguese hospital spanning 15 years. We analyzed maternal, admission-related, and neonatal variables from women admitted during pregnancy and up to 42 days post-delivery. Results: We identified 150 obstetric ICU admissions (0.9% of all ICU admissions, with an admission rate of 4.4 per 1000 deliveries). The mean age was 34 years, with most women being multiparous and 16.7% utilizing assisted reproductive technology. Notably, 45% of the women were above 35 years old. Most (86.7%) were admitted during the early postpartum period after undergoing a cesarean section (74%). The most frequent reasons for ICU admission were postpartum hemorrhage and hypertensive disorders of pregnancy. The mortality rate was 1.3%. The mean gestational age of newborns was 36 weeks and 6 days, and 46.4% were admitted to the neonatal ICU. We recorded one fetal death at 25 weeks and no neonatal deaths. Conclusions: The unique needs of obstetric ICU patients emphasize the need for specialized training of multidisciplinary teams. Severe postpartum hemorrhage was responsible for significant morbidity and disability, prompting a reassessment of delivery practices.