Clinical Characteristics and Maternal Outcome of Obstetrics Patients Admitted to the Intensive Care Unit: Cross Sectional Observational Study

Abstract

Background: According to UNICEF India, annually 44,000 women die due to preventable pregnancy related causes in India. Globally, this ratio is 830 maternal deaths daily according to a WHO newsletter from 2018. ICU / HDU facility provides simultaneous expert obstetrics care and critical medical care under one roof. The concept of ICU / HDU was introduced as a bridge between routine obstetric care and ICU / HDU in under to bypass and decrease the ICU / HDU burden. ICU / HDU care is required for women requiring more detailed observation, intervention including basic support for a single failing organ system, extended post-op care and those stepping down from higher levels of care. Awareness regarding ICU / HDU care and its benefits need to be improved. This study aims to study the maternal outcome of women admitted in tertiary care hospital, Karimnagar, Telangana.\nMethodology: This is cross sectional observational study was conducted in the department of obstetrics and gynaecology at Chalmeda Anand Rao Institute of Medical Sciences and hospital, Karimnagar, Telangana from June 2019 to March 2020 after obtaining clearance from the institutional scientific and ethical committees. In this study total 600 patients were recruited, out of these 150 patients not met the inclusion criteria & 450 women recruited for questionnaire based proforma, were selected for the study calculated by SPSS 20 software. They have been subjected to thorough history taking, general, obstetric examination and assessment of antenatal records & management & their outcome.\nResults: The mean age group is 25 yrs. Also found most admission in age group between 20 to 30 yr. Most of the cases were belong to low socioeconomic status (99.2%), Occupationally maximum were unskilled worker (98.3%) in present study, Most of the cases were have secondary level of education (91.6%). In this present study 180 were hypertensive disorder of pregnancy, followed by 128 were haemorrhage disorder of pregnancy, 108 were medical disorder of pregnancy & 34 were sepsis. Maternal mortality was 8.7% in this study.\nConclusion: Commonest cause of mortality was hypertensive disorder of pregnancy & more than one diagnosis on admission were the other risk factors for ICU / HDU admission. A dedicated ICU / HDU will go a long way in reducing maternal mortality as the responses time from onset of acute severe illness to provision of high quality critical care will be substantially reduced.\n\nKeywords: ICU / HDU, Maternal Outcome, Mortality, Critical Care Unit.