An evaluation of admission pattern and outcome in critically ill obstetric patients: two–year review in a tertiary care centre

Dr. Deepanshu Mallan; Dr Manish Kumar Singh; Dr Rajiv Ratan Singh Yadav; Dr Shiv Shanker Tripathi; Dr Sachin Avasthi

Volume : VI, Issue : IV, April - 2016

An evaluation of admission pattern and outcome in critically ill obstetric patients: two–year review in a tertiary care centre

Dr. Deepanshu Mallan, Dr Manish Kumar Singh, Dr Rajiv Ratan Singh Yadav, Dr Shiv Shanker Tripathi, Dr Sachin Avasthi

Abstract :

Objective: To evaluate the performance of the APACHE II score for the prediction of mortality in women with primary obstetric pathologies and those with coincidental pathologies while pregnant, using a highquality clinical database of admissions to general intensive care unit. Methods: This was an observational and prospective study conducted on Critically ill obstetric patients who required intensive care and/or required mechanical ventilation transferred in intensive care unit (ICU) from obstetrics and gynaecology department. A total of 120 patients were included. Results: Majority of patients were between 21–30 years. Most of obstetric admissions to ICU were following emergency surgery or nonsurgical with very few admissions following elective surgery. Pregnancy induced hypertension and its complications (eclampsia, HELLP syndrome, coagulopathy), obstetric haemorrhage and pelvic sepsis accounted for most of the obstetric indications. The ICU mortality rate was 21. Multiorgan dysfunction syndrome was the main cause of death. Overall Apache II score was 16±8 and Apache II predicted mortality was observed to be 28%. Conclusion: There was poor performance of APACHE II scoring system in the ICU obstetric subpopulation. APACHE II score over predicted mortality rate in critically ill obstetric patients.