Cuidados críticos obstétricos en una ciudad de mediano tamaño con recursos limitados: estudio retrospectivo

Objectives

This study aimed to assess demographic and clinicopathological features of obstetric patients admitted to the ICU in middle sized city, to discern the challenges and needs in critical obstetric care within the country.

Materials and methods

A retrospective cohort study was conducted at Clínica Materno Infantil Casa del Niño, encompassing all pregnant women admitted to the ICU from June 2014 to August 2018. We analyzed demographics, obstetric history, admission characteristics, and outcomes from electronic medical records. Logistic regression determined associations between admission characteristics and outcomes, including maternal mortality and ICU length of stay (LOS).

Results

Of 59.985 pregnant women, 0.52% (309) were admitted to the ICU. Predominant admission causes were hypertensive pregnancy disorders (80.5%) and pospartum hypovolemic shock (7.0%). The average maternal age was 25.4 years, with most admissions in the late preterm period. The ICU stay averaged 4.3 days, maternal mortality rate was 1.56%. Resource utilization included emergency cesarean delivery (83.6%), vasopressor therapy (21.0%), blood product requirement (16.73%), with some patients requiring mechanical ventilation and invasive monitoring.

Conclusions

The study report the obstetric care spectrum within ICU settings in a resource-limited environment, underscoring the necessity for improved antenatal care and enhanced response capacity within the ICU. The findings advocate for focused management strategies in critical care, implying healthcare policy reforms and practice changes in similar settings.