title: Epidemiologic profile, survival, and maternal prognosis factors among women at an obstetric intensive care unit.
abstract: OBJECTIVE
  To identify the epidemiologic profile, maternal survival, and prognosis factors that might affect survival rates in the obstetric intensive care unit (ICU).
  
  
  METHODS
  A prospective cohort study was conducted between January 2007 and February 2009 in a tertiary referral ICU, Belo Horizonte, Brazil. Critical patients during pregnancy and puerperium were followed from admission until discharge or death. Maternal survival was assessed in association with the cause of ICU admission, grouped into direct or indirect obstetric causes, by Kaplan-Meier curves and log-rank tests.
  
  
  RESULTS
  Among 298 patients admitted to the ICU during the study period, mortality was 4.7% (n=14). Hypertensive disorders (46.0%), hemorrhage (15.9%), sepsis (14.2%), and heart disease (5.7%) were the main causes of admission. Half of the patients who died were admitted for direct obstetric reasons (n=7). Survival was statistically linked to the cause of admission: most survivors were admitted for a direct obstetric cause (75.5%; P=0.044). Maternal survival rates of patients admitted for indirect obstetric causes were lower than those admitted for direct obstetric causes (27.8 and 19.6 days, respectively; P=0.019).
  
  
  CONCLUSIONS
  The main cause of admission was a decisive factor for maternal survival in the obstetric ICU. Direct obstetric complications had a better prognosis.
authors.affiliation: Department of Obstetrics and Gynaecology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. Electronic address: anarosaapereira@gmail.com.
authors.forename: Ana R A P
authors.initials: AR
authors.lastname: Bandeira
authors.affiliation: Department of Obstetrics and Gynaecology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Cezar A L
authors.initials: CA
authors.lastname: Rezende
authors.affiliation: Department of Obstetrics and Gynaecology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Zilma S N
authors.initials: ZS
authors.lastname: Reis
authors.affiliation: Maternidade Odete Valadares, Fundação Hospitalar de Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Achilles R
authors.initials: AR
authors.lastname: Barbosa
authors.affiliation: Maternidade Odete Valadares, Fundação Hospitalar de Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Frederico J A
authors.initials: FJ
authors.lastname: Peret
authors.affiliation: Department of Obstetrics and Gynaecology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Antônio C V
authors.initials: AC
authors.lastname: Cabral
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008875:Middle Aged; D009774:Obstetrics / Q000706:statistics & numerical data*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality*; D011379:Prognosis; D011446:Prospective Studies; D055815:Young Adult
keywords: Critical care; Intensive care unit; Maternal mortality; Obstetrics; Pregnancy; Severe maternal morbidity