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Maternal outcomes in critically ill obstetrics patients: A unique challenge

BACKGROUND: A pregnant woman is usually young and in good health until she suffers from some acute injury. Her prognosis will hopefully be better if she receives timely intensive care. MATERIALS AND METHODS: The aims of this study were to study the indications of medical intensive care unit (MICU) t...

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Autores principales: Bhadade, Rakesh, de’ Souza, Rosemarie, More, Anirudha, Harde, Minal
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3338247/
https://www.ncbi.nlm.nih.gov/pubmed/22557826
http://dx.doi.org/10.4103/0972-5229.94416
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author Bhadade, Rakesh
de’ Souza, Rosemarie
More, Anirudha
Harde, Minal
author_facet Bhadade, Rakesh
de’ Souza, Rosemarie
More, Anirudha
Harde, Minal
author_sort Bhadade, Rakesh
collection PubMed
description BACKGROUND: A pregnant woman is usually young and in good health until she suffers from some acute injury. Her prognosis will hopefully be better if she receives timely intensive care. MATERIALS AND METHODS: The aims of this study were to study the indications of medical intensive care unit (MICU) transfers for critically ill pregnant and postpartum females, biochemical and hematological profile, organ failure, ICU interventions, outcome of mother/fetus, APACHE II score and its correlation with mortality. STUDY DESIGN AND SETTING: It is a prospective observational study, carried out in the MICU of a tertiary care teaching hospital over a period of 18 months. One hundred and twenty-two pregnant and postpartum females (up to 42 days after delivery) were studied. RESULTS AND CONCLUSION: Maternal age >30 years was associated with high mortality (68.2%). Majority of the females were admitted in the third trimester (50 patients) and postpartum period (41 patients), and mortality was highest in the postpartum period (39%). Increasing parity and gravida was associated with significantly high mortality (59.5%). Acute viral hepatitis E (45 patients) was most common indication for MICU transfer, followed by malaria and pregnancy-induced hypertension. The mortality rate was 30.3%. The most common cause of death was acute viral hepatitis E (24 patients), with hepatic failure (53 patients) being the most common organ failure. Majority of the females (88 patients) were ANC registered. Low Glasgow coma score and high APACHE II score on admission were associated with significantly high mortality (85.2%). Prompt treatment with oseltamivir in H1N1 infection was associated with good maternal and fetal outcomes.
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spelling pubmed-33382472012-05-03 Maternal outcomes in critically ill obstetrics patients: A unique challenge Bhadade, Rakesh de’ Souza, Rosemarie More, Anirudha Harde, Minal Indian J Crit Care Med Research Article BACKGROUND: A pregnant woman is usually young and in good health until she suffers from some acute injury. Her prognosis will hopefully be better if she receives timely intensive care. MATERIALS AND METHODS: The aims of this study were to study the indications of medical intensive care unit (MICU) transfers for critically ill pregnant and postpartum females, biochemical and hematological profile, organ failure, ICU interventions, outcome of mother/fetus, APACHE II score and its correlation with mortality. STUDY DESIGN AND SETTING: It is a prospective observational study, carried out in the MICU of a tertiary care teaching hospital over a period of 18 months. One hundred and twenty-two pregnant and postpartum females (up to 42 days after delivery) were studied. RESULTS AND CONCLUSION: Maternal age >30 years was associated with high mortality (68.2%). Majority of the females were admitted in the third trimester (50 patients) and postpartum period (41 patients), and mortality was highest in the postpartum period (39%). Increasing parity and gravida was associated with significantly high mortality (59.5%). Acute viral hepatitis E (45 patients) was most common indication for MICU transfer, followed by malaria and pregnancy-induced hypertension. The mortality rate was 30.3%. The most common cause of death was acute viral hepatitis E (24 patients), with hepatic failure (53 patients) being the most common organ failure. Majority of the females (88 patients) were ANC registered. Low Glasgow coma score and high APACHE II score on admission were associated with significantly high mortality (85.2%). Prompt treatment with oseltamivir in H1N1 infection was associated with good maternal and fetal outcomes. Medknow Publications & Media Pvt Ltd 2012 /pmc/articles/PMC3338247/ /pubmed/22557826 http://dx.doi.org/10.4103/0972-5229.94416 Text en Copyright: © Indian Journal of Critical Care Medicine http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Bhadade, Rakesh
de’ Souza, Rosemarie
More, Anirudha
Harde, Minal
Maternal outcomes in critically ill obstetrics patients: A unique challenge
title Maternal outcomes in critically ill obstetrics patients: A unique challenge
title_full Maternal outcomes in critically ill obstetrics patients: A unique challenge
title_fullStr Maternal outcomes in critically ill obstetrics patients: A unique challenge
title_full_unstemmed Maternal outcomes in critically ill obstetrics patients: A unique challenge
title_short Maternal outcomes in critically ill obstetrics patients: A unique challenge
title_sort maternal outcomes in critically ill obstetrics patients: a unique challenge
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3338247/
https://www.ncbi.nlm.nih.gov/pubmed/22557826
http://dx.doi.org/10.4103/0972-5229.94416
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