title: The role of the post-anaesthesia care unit in the management of high-risk obstetric patients.
abstract: BACKGROUND
  High-risk obstetric patients in the immediate postpartum period are frequently admitted to the intensive care unit, but the necessity of this practice has recently been doubted. Herein we describe the efficiency of utilizing the post-anaesthesia care unit (PACU) as an intermediate intensive care facility for those patients.
  
  
  METHODS
  We retrospectively described the reasons for admission, duration of stay, the anaesthetic used, main interventions and outcome for all obstetric admissions in the PACU during a period of 4 years in a university hospital.
  
  
  RESULTS
  During the 4-year period 47 women were admitted to the PACU after delivery. The frequency of admission to the PACU was 15.3 per 1000 deliveries, while obstetric cases represented 4.4 per 1000 admissions to the PACU. The majority represented caesarean sections (81%). The main reasons for admission to the PACU were haemorrhage (49%), cardiovascular problems (19%) and preeclampsia/eclampsia (17%). Mean length of stay in the PACU was 14.5 ±11.6 h, being significantly less in women having received epidural anaesthesia (8.2 ±5.6 h) compared to those who delivered with general anaesthesia (19.0 ±13.6 h, p < 0.05). General anaesthesia was used in 85% of cases in which emergency delivery was indicated, but only in 27% of cases without emergency indications for delivery (p < 0.01). No death or admission to the intensive care unit occurred during the study period.
  
  
  CONCLUSIONS
  The PACU can offer an intermediate intensive care facility for high-risk obstetric patients, thus reducing unnecessary admissions to the intensive care unit.
authors.affiliation: 2  Department of Anaesthesiology, University of Athens School of Medicine, Attikon Hospital, Athens, Greece.
authors.forename: Georgia
authors.initials: G
authors.lastname: Kostopanagiotou
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Kalimeris
authors.forename: Aggeliki
authors.initials: A
authors.lastname: Pandazi
authors.forename: George
authors.initials: G
authors.lastname: Salamalekis
authors.forename: Charalampos
authors.initials: C
authors.lastname: Chrelias
authors.forename: Paraskevi
authors.initials: P
authors.lastname: Matsota