title: Obstetric admissions to ICUs in Finland: A multicentre study.
abstract: In this study, the objective was to describe and analyse reasons for obstetric admissions to the ICU, severity of illness, level and types of interventions, adverse events and patient outcomes. In a retrospective database study, we identified 291 obstetric patients during pregnancy and puerperium from four Finnish university hospitals. Most were admitted in the post-partum period and hypertensive disorders were the main indications for admissions, followed by obstetric haemorrhage. The median length of stay was 21hours. The most common intervention was blood transfusion and mechanical ventilation was required in nearly one fifth of the patients. Three patients had a prolonged stay and nine had re-admissions. One maternal death was recorded. This study found that severity of illness and organ failure scores describe the obstetric patient as having a good probability of recovery and a short length of stay. However, the obstetric patients reason for admission and their type of delivery were associated with both the severity of illness scores and level of intervention required. Those admitted for non-obstetric reasons and having had a vaginal delivery demonstrated higher severity of illness scores, organ failure scores, and levels of intervention when compared to those admitted for obstetric reasons or those who had delivered by caesarean section. In conclusion, care of these patients can be improved by understanding the severity of illness scores, common ICU interventions and patient outcomes.
authors.affiliation: University of Tampere, School of Health Sciences, FI-33014 University of Tampere, Finland. Electronic address: seppanen.pia.m@student.uta.fi.
authors.forename: Pia
authors.initials: P
authors.lastname: Seppänen
authors.affiliation: Centre for Research Methods, Department of Social Research, University of Helsinki, PO BOX 54, FI-00014 University of Helsinki, Finland. Electronic address: reijo.sund@helsinki.fi.
authors.forename: Reijo
authors.initials: R
authors.lastname: Sund
authors.affiliation: University of Tampere, School of Health Sciences, FI-33014 University of Tampere, Finland. Electronic address: mervi.roos@uta.fi.
authors.forename: Mervi
authors.initials: M
authors.lastname: Roos
authors.affiliation: Tampere University Hospital, Intensive Care Unit, PO BOX 2000, FI-33521 Tampere, Finland. Electronic address: riitta.unkila@pshp.fi.
authors.forename: Riitta
authors.initials: R
authors.lastname: Unkila
authors.affiliation: Oulu University Hospital, PO BOX 21, FI-90029 Oulu, Finland. Electronic address: merja.merilainen@ppshp.fi.
authors.forename: Merja
authors.initials: M
authors.lastname: Meriläinen
authors.affiliation: University of Tampere, School of Health Sciences, FI-33014 University of Tampere, Finland; Science Centre, Pirkanmaa Hospital District, PO BOX 2000, FI-33521 Tampere, Finland. Electronic address: mika.helminen@uta.fi.
authors.forename: Mika
authors.initials: M
authors.lastname: Helminen
authors.affiliation: Oulu University Hospital, PO BOX 21, FI-90029 Oulu, Finland. Electronic address: tero.ala-kokko@ppshp.fi.
authors.forename: Tero
authors.initials: T
authors.lastname: Ala-Kokko
authors.affiliation: University of Tampere, School of Health Sciences, FI-33014 University of Tampere, Finland. Electronic address: tarja.suominen@uta.fi.
authors.forename: Tarja
authors.initials: T
authors.lastname: Suominen
mesh_terms: D000328:Adult; D005260:Female; D005387:Finland; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000628:therapy; D007362:Intensive Care Units / Q000458:organization & administration* / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D007744:Obstetric Labor Complications / Q000451:nursing*; D010343:Patient Admission / Q000706:statistics & numerical data*; D006473:Postpartum Hemorrhage / Q000628:therapy; D011247:Pregnancy; D012189:Retrospective Studies
keywords: Adverse event; Interventions; Obstetric patient; Outcome; Severity of illness