Obstetric and Gynaecologic Patients Requiring Intensive Care: A One Year Retrospective Study in a Tertiary Teaching Hospital in Bangladesh

Abstract

Background: Care of obstetric patients has always been a challenge for obstetricians and critical carephysicians, because of the consideration of multidimensional pregnancy related diseases as well asfoetal wellbeing. Objective: The aim of the study was to evaluate the incidence, indications for admission,interventions and consequences of the obstetrics and gynaecologic patients admitted to the ICU. Methods: A retrospective observational study was conducted in the multidisciplinary ICU of EnamMedical College and Hospital from January, 2020-December, 2020.All the obstetric and gynae patientsadmitted to the ICU were the study population. Data regarding demographic characteristics of thepatients, indications for admission, associated medical disorders, interventions, length of ICU stay,and outcome were collected and analyzed. Results: During the study period, total 870 patients were admitted to the ICU, among which the dataof 90(10.3%) patients were analyzed. The mean age of the patients was 26.84±6.95years. Total 63% ofthe patients came from rural area. Obstetric cases were 72% and gynaecological cases were 28%.Among the obstetric cases 22% had post-partum Eclampsia, 12% cases had preeclampsia, another 12%had PPH, and 9%cases had APH. Among the gynaecological reasons, 52% cases were ruptured ectopicpregnancy, and 36% cases had post abortion complications. Majority (64.61%) admitted in theirpostpartum period. Inotropes were needed for 36.7%. Transfusion of blood and blood products wererequired for 51.1%. Mechanical ventilation was needed for 31.8%. The majority of the patients 63.3%stayed in the ICU for a period of 1-3 days. Maternal mortality was 12.2% (11). Most common cause formaternal death was MODS 4(36.36%). Conclusion: Hypertensive disorders account for the most number of admission to ICU followed byobstetric haemorrhage.Early detection and speedy referral to the tertiary center with ICU facilitiesshould be promoted among medical society to reduce the incidence of ICU admissions and maternalmortality. JBSA 2021; 34 (2) : 49-54