Clinical profile and outcomes of critically ill obstetric patients in the intensive care unit of a tertiary care center

Table 1 Demographics and indications of intensive care unit admission of obstetric patients (n = 101), mean ± SD/n (%)

Variable
Age	27.84 ± 5.2
Comorbidities	23 (22.8)
Heart disease	13 (56.5)
Gestational diabetes	5 (21.7)
Hypertension	5 (21.7)
Antenatal checkup
Booked	96 (95.04)
Un booked	5 (4.95)
Gravida
Primigravida	27 (26.7)
Multigravida	74 (73.2)
Time of admission
First trimester	7 (6.9)
Second trimester	6 (5.9)
Third trimester	14 (13.8)
Postpartum	74 (73.2)
Twin pregnancy	2 (1.98)
Mode of delivery
Cesarean section	59 (58.4)
Normal delivery	30 (29.7)
Abortion	8 (7.9)
Laparotomy	4 (3.9)
Fetal outcome
Live	82 (81.1)
IUD	13 (12.8)
Still birth	3 (2.9)
Ectopic	3 (2.9)
Indications of ICU admission
Hypertensive disorder of pregnancy	21 (20.7)
Pre-eclampsia	6 (5.9)
Eclampsia	12 (11.8)
HELPP	3 (2.9)
PPH	20 (19.8)
Heart disease	13 (12.8)
Puerperal sepsis	5 (4.9)
Ectopic pregnancy	3 (2.9)

IUD: Intrauterine device; ICU: Intensive care unit; HELPP: Hemolysis, elevated liver enzymes and low platelets; PPH: Postpartum hemorrhage.

Table 2 Non-obstetric causes of admission to the intensive care unit

Indication for ICU admission	n (%)
CAP	9 (8.9)
Sepsis	7 (6.9)
AKI	5 (4.9)
Pancreatitis	4 (3.9)
Stroke	4 (3.9)
Encephalopathy	3 (2.9)
Encephalitis	1 (0.9)
PRES	2 (1.9)
SAH	2 (1.9)
Trauma	1 (0.9)
Tuberculoma	1 (0.9)

ICU: Intensive care unit; CAP: Community-acquired pneumonia; AKI: Acute kidney injury; PRES: Posterior reversible encephalopathy syndrome; SAH: Subarachnoid hemorrhage.

Table 3 Indications for intensive care unit admission

Indication	n (%)
Hemodynamic instability	40 (39.6)
Respiratory distress	18 (17.8)
Neurological impairment	27 (26.7)
AKI	9 (8.9)
Monitoring	7 (6.9)

AKI: Acute kidney injury.

Table 4 Critical care interventions required in obstetric patients admitted to the intensive care unit

Intervention	n (%)
Need for mechanical ventilation	68 (67.3)
RRT	27 (26.7)
CVC	66 (65.3)
Arterial line	70 (69.3)
Vasopressor required	54 (53.5)
Blood transfusion	54 (53.5)

RRT: Renal replacement therapy; CVC: Central venous line.

Table 5 Relationship between diagnosis and mortality in obstetric patients admitted to the intensive care unit, n (%)

Diagnosis	Mortality
PPH	7 (25)
Hypertensive disorders of pregnancy	3 (10.7)
CAP	3 (10.7)
Puerperal sepsis	1 (3.6)
Non-obstetric causes	14 (50)

PPH: Postpartum haemorrhage; CAP: Community-acquired pneumonia.

Table 6 Comparison of mortality prediction scores between survivors and non-survivors, median (interquartile rage)

Score	Survivors	Non-survivors	P value
MEOWS	4 (3-5)	6 (4-7)	< 0.0001
APACHE II	12 (8-16)	21 (14-26.5)	< 0.001
SOFA	4 (3-5)	5 (4-6)	0.016
SAPS II	23 (18-30)	36 (28.7-43)	< 0.001

MEOWS: Modified Early Obstetric Warning Score; APACHE II: Acute Physiology and Chronic Health Evaluation II; SOFA: Sequential Organ Failure Assessment; SAPS II: Simplified Acute Physiology Score II.