Abstract :
Introduction: Critically ill obstetric patients need intensive care unit (ICU) admission, as pregnancy and delivery can involve complications that necessitate admission to (ICU). The management of critically ill obstetric patients is complex due to the physiological changes and pregnancy-specific diseases that require proper management by both intensivists and obstetricians. Aim of the Work: Our work studied critically ill obstetric patients admitted to the ICU at Riyadh care hospital retrospectively over a period of 3 years to evaluate the incidence , indications and outcoiv.e of obstetric patients requiring ICU admission. Patients and Methods: The study was based on all obstetric patients admitted to the ICU during the ante partum or postpartum. We collected baseline data and acute physiology and chronic health evaluation II (APACHE II) scores. ICU mortality was the primary outcome. Patients were grouped into obstetric or medical cases according to the admitting diagnosis. Results: Seventy obstetric patients were admitted to the ICU over 3 years, 36 of these patients (51.4 %) were admitted during the antepartum period. The primary obstetric indication for ICU admission was pregnancy-induced hypertension (22 patients, 31.4%) , followed by postpartum haemorrhage (18 patients 25.7%). On the other hand sepsis was presented as the leading nonobstetric admission(8 patients, 11.4%). The mean APACHE II score was 19.6. The predicted mortality rate based on the APACHE II score was 22% ,however, only 4 maternal deaths (5.7%) were among the obstetric patients admitted to the ICU. Conclusion: Pregnancy-induced hypertension (PIH) was the most common obstetric indication for ICU admission, followed by obstetric haemorrhage. Evaluation of obstetric patients by (APACHE II) scores showed higher predicted mortality rate, however the overall mortality was lower. Regular follow up, together with early detection of complications and prompt ICU admission necessitating proper management by specialized team can improve mortality.
