Meshram TM, Sharma A, Kothari N, Das AK, Choudhary G, Rathod D, Kumari K, Bhatia PK. Clinical profile and outcomes of critically ill obstetric patients in the intensive care unit of a tertiary care center. World J Crit Care Med 2026; 15(2): 118246 [DOI: 10.5492/wjccm.v15.i2.118246]
Corresponding Author of This Article
Ankur Sharma, MD, Additional Professor, Consultant, Department of Trauma and Emergency (Anesthesiology & Critical Care), AIIMS Jodhpur, Basni Phase‑II, Jodhpur 342008, Rājasthān, India. ankuranaesthesia@gmail.com
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Critical Care Medicine
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Retrospective Study
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Meshram TM, Sharma A, Kothari N, Das AK, Choudhary G, Rathod D, Kumari K, Bhatia PK. Clinical profile and outcomes of critically ill obstetric patients in the intensive care unit of a tertiary care center. World J Crit Care Med 2026; 15(2): 118246 [DOI: 10.5492/wjccm.v15.i2.118246]
World J Crit Care Med. Jun 9, 2026; 15(2): 118246 Published online Jun 9, 2026. doi: 10.5492/wjccm.v15.i2.118246
Clinical profile and outcomes of critically ill obstetric patients in the intensive care unit of a tertiary care center
Tanvi M Meshram, Ankur Sharma, Nikhil Kothari, Akshaya Kumar Das, Garima Choudhary, Darshana Rathod, Kamlesh Kumari, Pradeep K Bhatia
Tanvi M Meshram, Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Nagpur 441108, Mahārāshtra, India
Ankur Sharma, Department of Trauma and Emergency (Anesthesiology & Critical Care), AIIMS Jodhpur, Jodhpur 342008, Rājasthān, India
Nikhil Kothari, Akshaya Kumar Das, Garima Choudhary, Darshana Rathod, Kamlesh Kumari, Pradeep K Bhatia, Department of Anesthesia and Critical Care, AIIMS Jodhpur, Jodhpur 342008, Rājasthān, India
Co-first authors: Tanvi M Meshram and Ankur Sharma.
Author contributions: Meshram TM, Sharma A contributed to design conception and they contributed equally to this manuscript and are co-first authors; Meshram TM, Sharma A, and Kothari N contributed to writing and editing the manuscript; Meshram TM, Sharma A, Das AK, and Choudhary G contributed to data collection; Meshram TM, Sharma A, and Rathod D contributed to drafting of the manuscript; Das AK and Kumari K contributed to statistical analysis; Rathod D contributed to acquisition, analysis, and interpretation of data; Kumari K and Bhatia PK critical revision of the manuscript for important intellectual content. All authors approval the final manuscript.
Institutional review board statement: This retrospective study was approved by the Ethics Committee of All India Institute of Medical Sciences (Approval No. AIIMS/IEC/2022/4090).
Informed consent statement: Informed consent was waived due to the retrospective nature of the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: All data generated or analyzed during this study are included in this published article.
Corresponding author: Ankur Sharma, MD, Additional Professor, Consultant, Department of Trauma and Emergency (Anesthesiology & Critical Care), AIIMS Jodhpur, Basni Phase‑II, Jodhpur 342008, Rājasthān, India. ankuranaesthesia@gmail.com
Received: December 28, 2025 Revised: February 7, 2026 Accepted: March 16, 2026 Published online: June 9, 2026 Processing time: 145 Days and 3.5 Hours
Abstract
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.
Core Tip: Critically ill obstetric patients admitted to a tertiary care intensive care unit demonstrated a high mortality rate, with hypertensive disorders of pregnancy and obstetric hemorrhage being the leading causes of intensive care unit admission and death. Severity scoring systems were found to be effective in predicting patient outcomes, emphasizing their usefulness in early risk stratification and clinical decision-making. These findings highlight the importance of timely referral, early recognition of complications, and the establishment of dedicated obstetric critical care services to improve maternal outcomes.
