World journal of critical care medicine · 2026
Clinical profile and outcomes of critically ill obstetric patients in the intensive care unit of a tertiary care center.
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Meshram Tanvi M, Sharma Ankur, Kothari Nikhil, Das Akshaya Kumar, Choudhary Garima, Rathod Darshana, Kumari Kamlesh, Bhatia Pradeep K
Аннотация
BACKGROUND: Although obstetric patients account for only 1%-2% of general intensive care unit (ICU) admissions, they constitute a distinct population with unique physiological characteristics and risk profiles. Therefore, understanding the clinical profile of these patients is essential for their appropriate management.
AIM: To evaluate clinical characteristics, outcomes, and mortality predictors among obstetric patients admitted to a multidisciplinary ICU, and to assess the performance of established severity scoring systems in this unique population.
METHODS: We conducted a retrospective study of all obstetric patients (pregnant or ≤ 6 weeks postpartum) admitted to the ICU of a tertiary care teaching hospital from January 2020 to April 2022. Primary outcomes included mortality rates and length of stay. Secondary outcomes included evaluation of Acute Physiology and Chronic Health Evaluation II, Sequential Organ Failure Assessment, Simplified Acute Physiology Score II, and Modified Early Obstetric Warning Score systems for mortality prediction.
RESULTS: During the research period, 101 patients were admitted to the ICU. The documented mortality rate was 27.7% among these patients admitted to the ICU. The predominant reason for ICU hospitalization was hypertensive disorders of pregnancy (20.7%), followed by postpartum hemorrhage (19.8%). Mechanical ventilation was necessitated in 67.3% of parturient. Cesarean delivery was the most common mode of delivery (58.4%). Fetal outcomes included 81.1% live births, 12.8% intrauterine deaths, and 2.9% stillbirths. Acute Physiology and Chronic Health Evaluation II, Simplified Acute Physiology Score II, Modified Early Obstetric Warning Score, and Sequential Organ Failure Assessment scores of 21 (14-26.5), 36 (28.7-43), 6 (4-7), and 5 (4-6) significantly predicted mortality (P < 0.05) in non-survivors.
CONCLUSION: Parturient may present to the critical care unit with hypertensive disorders, hemorrhage, morbidly adherent placenta, and other non-obstetric causes demanding obstetric and critical care. The availability of a dedicated obstetric critical care unit with specialized personnel would help decrease the mortality in this subset of patients.
AIM: To evaluate clinical characteristics, outcomes, and mortality predictors among obstetric patients admitted to a multidisciplinary ICU, and to assess the performance of established severity scoring systems in this unique population.
METHODS: We conducted a retrospective study of all obstetric patients (pregnant or ≤ 6 weeks postpartum) admitted to the ICU of a tertiary care teaching hospital from January 2020 to April 2022. Primary outcomes included mortality rates and length of stay. Secondary outcomes included evaluation of Acute Physiology and Chronic Health Evaluation II, Sequential Organ Failure Assessment, Simplified Acute Physiology Score II, and Modified Early Obstetric Warning Score systems for mortality prediction.
RESULTS: During the research period, 101 patients were admitted to the ICU. The documented mortality rate was 27.7% among these patients admitted to the ICU. The predominant reason for ICU hospitalization was hypertensive disorders of pregnancy (20.7%), followed by postpartum hemorrhage (19.8%). Mechanical ventilation was necessitated in 67.3% of parturient. Cesarean delivery was the most common mode of delivery (58.4%). Fetal outcomes included 81.1% live births, 12.8% intrauterine deaths, and 2.9% stillbirths. Acute Physiology and Chronic Health Evaluation II, Simplified Acute Physiology Score II, Modified Early Obstetric Warning Score, and Sequential Organ Failure Assessment scores of 21 (14-26.5), 36 (28.7-43), 6 (4-7), and 5 (4-6) significantly predicted mortality (P < 0.05) in non-survivors.
CONCLUSION: Parturient may present to the critical care unit with hypertensive disorders, hemorrhage, morbidly adherent placenta, and other non-obstetric causes demanding obstetric and critical care. The availability of a dedicated obstetric critical care unit with specialized personnel would help decrease the mortality in this subset of patients.