Article Text
Abstract
Unplanned admission to intensive care unit (ICU) is a useful quality assurance indicator in obstetrics. 59 obstetric patients were admitted to ICU in Craigavon Area Hospital between January 1998 and December 2008, due to conditions caused or exacerbated by pregnancy. This was an overall admission rate of 1.78 per 1000 deliveries for the 10-year period. As with published data, there was a general rise in the number of admissions over the study period. In the series, 92% of patients were postnatal, and the most common cause for admission was haemorrhage (23/59, 39%) followed by hypertensive disorders of pregnancy (17/59, 29%), with a range of other conditions accounting for the remainder.
Of the postnatal patients, 71% were delivered by emergency C Section, 9% by elective Caesarean section, 3% by instrumental delivery and 17% following normal vaginal delivery. No maternal deaths occurred between 1998 and 2008, but in 5% of cases with ICU admission the baby was stillborn, and an early neonatal death occurred in 8% of cases.
Cause | Patients (N) | % |
---|---|---|
Anaphylaxis | 3 | 5.1 |
APH | 5 | 8.5 |
Respiratory | 5 | 8.5 |
PPH | 18 | 30.5 |
Pre-eclampsia | 10 | 16.9 |
Eclampsia | 3 | 5.1 |
HELLP syndrome | 4 | 6.8 |
Sepsis | 4 | 6.8 |
Collapse | 2 | 3.4 |
Status epilepticus | 1 | 1.7 |
First trimester | 2 | 3.4 |
Psychosis | 1 | 1.7 |
Thromboembolism | 1 | 1.7 |
APH, antepartum haemorrhage; HELLP, Hemolysis, Elevated Liver enzyme levels and a Low Platelet count; PPH, post partum haemorrhage.