EVALUATING THE MATERNAL OUTCOME IN OBSTETRIC ICU A STUDY FROM A TERITIARY CARE HOSPITAL IN SOUTH INDIA

Background : Critically ill obstetric patients pose challenges to the intensive care unit team due to their altered physiology as well as due the presence of the foetus and safety of both the mother and the foetus is of most important. A better knowledge of the spectrum, characteristics and outcomes of the diseases involving this group of patients is the first step towards achieving prevention and the current study is done to supplement the present knowledge on obstetric emergencies requiring ICU care. Aims and Objectives :The objective is to study the profile of cases admitted to obstetric ICU and to evaluate maternal outcome and prognosis. Materials and Methods :This is observational study was conducted at Andhra Medical College ,visakhapatnam a teritiary care hospital from January 2022 to June 2022 . 1. All antenatal women irrespective of the period of gestation and postnatal women within 42 days of delivery requiring ICU admission for obstetric, non-obstetric reasons,irrespective of age, parity, mode of delivery, and co-morbid conditions were included . 2. Results were subjected to statistical analysis and conclusions drawn. Results : During the study period of 6 months, a total number of 82 obstetric patients were admitted to ICU. Specific interventions that had been undertaken at the ICU (such as the use of intubation, mechanical ventilation, and intensive monitoring )were recorded. The complications that were encountered at the ICU, such as disseminated intravascular coagulation (DIC) and multiorgan failure, were recorded. Majority were of obstetric reasons (n=58, 70.7%).Non-obstetric reasons (n=24, 29.3%) 28 maternal deaths occurred during the study period.Most common cause of death in our study was MODS followed by complications of hypertensive disorders of pregnancy. Discussion : Present centre being a tertiary care hospital majority of the women had severe complications and many were referred after a significant amount of delay .This stresses the idea that, in cases involving obstetric patients, there could not be much time for transfer to an intensive care unit and that things could swiftly deteriorate. Lack of antenatal care, poor socio economic background, delay in referral from the peripheral health centres predicted poor outcomes. Conclusion : The findings of the present study reinforce the statement by WHO that There is a story behind every maternal death or life-threatening complication. Understanding the lessons to be learned can help to avoid such outcomes. A multidisciplinary team approach is required in ICU. All residents of obstetrics and gynaecology should have short mandatory training phase in critical care.