A fifteen-year retrospective review of obstetric patients requiring critical care

Barrett, Helen L., Devin, Ruth, Clarke, Sophie, Nitert, Marloes Dekker, Boots, Robert, Fagermo, Narelle, Callaway, Leonie K. and Lust, Karin (2012) A fifteen-year retrospective review of obstetric patients requiring critical care. Obstetric Medicine, 5 4: 166-170. doi:10.1258/om.2012.120033

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Author Barrett, Helen L.
Devin, Ruth
Clarke, Sophie
Nitert, Marloes Dekker
Boots, Robert
Fagermo, Narelle
Callaway, Leonie K.
Lust, Karin
Title A fifteen-year retrospective review of obstetric patients requiring critical care
Journal name Obstetric Medicine   Check publisher's open access policy
ISSN 1753-495X
Publication date 2012-12
Sub-type Article (original research)
DOI 10.1258/om.2012.120033
Volume 5
Issue 4
Start page 166
End page 170
Total pages 5
Place of publication London, United Kingdom
Publisher Sage Publications
Collection year 2013
Language eng
Formatted abstract
Background: Maternal mortality is a rare occurrence in developed nations. Given the low maternal mortality rate, other markers must be used to assess maternal risk and quality of obstetric care. One such is admission to critical care.
Aims: To determine the rate of admission, diagnosis and management of women from conception and up to 6 weeks postpartum to critical care units including coronary care (CCU), high dependency unit (HDU) and intensive care units (ICU).
Methods: We performed a retrospective review of obstetric patients requiring critical care admission from January 1995 to August 2010. Demographic details, obstetric history, place of admission (CCU, HDU or ICU) and fetal/neonatal outcomes were examined as were initial indication for critical care admission, final diagnosis and treatment administered.
Results: Data were available from 308 admission incidents. There were 259 (84%) admissions to ICU and 49 (15.9%) to CCU. More than a third of women were transferred from another institution. Those women transferred were more unwell and had a higher mortality rate than local women. Primary diagnoses: obstetric haemorrhage (ICU 30.9%), hypertensive disorders of pregnancy
(ICU 16.2%, CCU 12.2%), infection (ICU 14.2%, CCU 6.1%), pre-existing cardiac disease (ICU 9.3%, CCU 55.1%).
Conclusions: The obstetric population represents only a small percentage of critical care utilisation and overall morbidity and mortality. However, this population is an important and growing group. Increased surveillance peripartum in a critical care facility allows earlier detection of maternal compromise and detailed management. Analysis of these ‘near misses’ in obstetrics aims to improve pregnancy outcomes.
Keyword High risk pregnancy
Intensive care medicine
Maternal Mortality
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: UQ Centre for Clinical Research Publications
Official 2013 Collection
School of Medicine Publications
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Created: Tue, 14 May 2013, 15:28:30 EST by Leonie Callaway on behalf of Royal Brisbane Clinical School