Obstetric admissions to the intensive care unit in a tertiary referral hospital.
OBJECTIVE
The present study was conducted to evaluate the obstetric admissions to the intensive care unit (ICU) in the setting of a tertiary referral hospital in an attempt to identify the risk factors influencing maternal outcome.


METHODS
All of the obstetric patients who seeked care for delivery at the emergency department and who were admitted to the ICU between January 2006 to July 2009 were retrospectively identified. The Simplified Acute Physiology Score (SAPS II) was calculated and the maternal mortality rate was estimated for each patient. The mean SAPS II scores and the mean estimated maternal mortality rates for the surviving patients and the nonsurviving patients were compared.


RESULTS
Seventy-three obstetric patients were admitted to the ICU. There were 9 maternal deaths and 24 fetal deaths. For the surviving group of patients, the mean SAPS II score was 34 and estimated maternal mortality rate was 20%, whereas for the nonsurviving group of patients, the SAPS II score was 64 and estimated maternal mortality rate was 73%. The difference between the surviving group of patients and the nonsurviving group of patients was statistically significant regarding both the mean SAPS II scores and the mean estimated maternal mortality rates.


CONCLUSIONS
Pregnancy-induced hypertensive disorders and hemorrhage appear as the major risk factors influencing maternal outcome in obstetric patients. Considering that the use of the SAPS II scores have enabled the reliable estimation of the mortality rates in the present study, the attempts at defining the focus of care for the obstetric patients who bear the major risk factors and who are admitted to the ICU should be carried out under the guidance of the ICU scoring systems such as the SAPS II.
Togal
Turkan
T
Department of Anesthesiology and Reanimation, School of Medicine, Inonu University, Malatya 44315, Turkey. ttogal@inonu.edu.tr
Yucel
Neslihan
N
Gedik
Ender
E
Gulhas
Nurcin
N
Toprak
H Ilksen
HI
Ersoy
M Ozcan
MO
D000328:Adult; D036861:Delivery, Obstetric; D004632:Emergency Medical Services; D005260:Female; D046689:Fetal Mortality; D006470:Hemorrhage / Q000401:mortality; D017052:Hospital Mortality; D006761:Hospitals; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000401:mortality; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008428:Maternal Mortality; D010343:Patient Admission / Q000706:statistics & numerical data*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000401:mortality* / Q000628:therapy; D011256:Pregnancy Outcome; D012017:Referral and Consultation; D012189:Retrospective Studies; D012307:Risk Factors; D014421:Turkey; D055815:Young Adult