Pregnancy related and postpartum admissions to intensive care unit in the obstetric tertiary care center - an 8-year retrospective study.

OBJECTIVES: The purpose of the study was to analyze the incidence of maternal morbidity and mortality of pregnant and postpartum women admitted to the intensive care unit (ICU).

MATERIAL AND METHODS: Retrospective analysis of all pregnant and postpartum patients admitted to ICU of the obstetric tertiary care center between January 1, 2007 and December 31, 2014.

RESULTS: A total of 266 patients with pregnancy and postpartum related morbidity were admitted to ICU (12.56 per 1000 deliveries). It accounted for 21.08% of all adult admissions of the unit. Mean age was 30.2 ± 5.6 years, mean gestational age was 30.8 ± 7.6 weeks. Two hundred forty patients (90.23%) were primiparous, 17 (6.4%) were twin pregnancy. Main reasons of admission included hypertensive disorders of pregnancy n = 99 (37.22%; 4.68 per 1000 deliveries), hemorrhage n = 46 (17.29%; 2.17 per 1000 deliveries) and sepsis/infection n = 46 (17.29%; 2.17 per 1000 deliveries). Median length of stay was five days (IQR 4-7). Artificial ventilation was required in 91 patients (34.21%), 147 (55.26%) required vasoactive drugs, 33 (12.41%) had metabolic disturbances, 21 (7.89%) required total parenteral nutrition and 4 (1.50%) renal replacement therapy. We report four maternal deaths (1.5%; 0.19 per 1000 deliveries).

CONCLUSIONS: There are three main reasons of obstetric ICU admissions: hypertensive disorders of pregnancy, obstetric hemorrhage and sepsis/infection. The majority of obstetric patients admitted to ICU did not require multi-organ supportive therapy. Availability of intermediate care facility could reduce unnecessary admission to ICU.