Retrospective review of critically ill obstetrical patients: a decade's experience

Authors: TUNCER ŞİMŞEK, CAN EYİGÖR, MEHMET UYAR, SEMRA KARAMAN, ALİ REŞAT MORAL

Abstract: To investigate the reasons for the admission of obstetrical patients to the intensive care unit (ICU) and their clinical outcomes, to compare the roles of the current scoring systems in estimating the mortality of these patients, and to determine adverse prognostic factors in critically ill obstetrical patients. Materials and methods: Data were retrospectively obtained from obstetrical patients admitted to the ICU in our institution between January 1999 and April 2009. Demographic characteristics, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Sequential Organ Failure Assessment (SOFA) score, and Glasgow Coma Scale (GCS) score of patients at the time of their first ICU admission were recorded. Patients were divided into 2 groups for comparison: Group 1, patients who died in the ICU, and Group 2, patients who were discharged from the ICU. Results: Preeclampsia, eclampsia, and the hemolysis, elevated liver enzymes, and low platelet count syndrome (HELLP) were the most common diagnoses requiring ICU admission (65.1%). APACHE II, SOFA, and GCS values were significantly worse in Group 1 patients compared with Group 2 patients (P < 0.05). Conclusion: Scoring systems help to determine the probability of mortality in obstetrical patients. Utilizing these scoring systems may prevent both the unnecessary admission of low-risk patients and delayed ICU care for critically ill patients.

Keywords: Obstetrical patients, intensive care, maternal mortality, maternal morbidity

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