Study of Critically ill Patients with Obstetric Complications at Intensive Respiratory Care Unit, King George Hospital, Visakhapatnam

Abstract

Aim: Obstetric emergencies are a unique challenge particularly because of its unpredictability. This study is to analyze the obstetric admissions to IRCU. Outcome in these patients is assessed. Risk stratification was done. Methods: This is a prospective study conducted over period of 1year, from January 2019-December 2019, King George Hospital, Visakhapatnam. All pregnant women and up to 42 days of postpartum who were admitted to IRCU were included. It is a tertiary care hospital with IRCU facilities not only to its own patients but also to the referrals from peripheries and other districts. Results: There were 142 obstetric admissions to IRCU accounting for 1.8% of total deliveries. 52.8% were in the age group of 20-25 years. 46.47% were in their first pregnancy. A majority of patients were admitted during postpartum period (69.71%). The leading obstetric indications for ICU admission were hypertensive disorders of pregnancy accounts for 44.3%. 12.67% of cases underwent emergency hysterectomy and 5.63% underwent emergency laparotomy. 57.04% need mechanical ventilation, 56.33 % need inotropic support. 57.7 % of individuals improved after treatment. In this study mortality was 42% of which 95% were referred from peripheries and surrounding districts in a severe morbid condition. Among the 142 obstetric admission to IRCU 85.9% were referrals. Conclusion: Common risk factors for ICU admissions are hypertensive disorders of pregnancy and obstetric hemorrhage. Other risk factors are severe anemia, heart disease, sepsis. It conclude that close follow up, early referrals of high risk pregnancies and optimal stabilization of their condition, safe transport, better education, before interventions improved the outcome of these patients.