scholarly journals Study of outcome of obstetric emergencies admitted to intensive care unit

2018 ◽  
Vol 7 (7) ◽  
pp. 2909
Author(s):  
B. Rao Bahadur ◽  
Prabhadevi Kodey ◽  
Jeevitha Tanniru ◽  
Suhasini Tirumala
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Maternal Mortality ◽  
National Guidelines ◽  
Intensive Care Unit Team ◽  
Tertiary Centre ◽  
Mandatory Training ◽  
Care Facilities ◽  
Obstetric Emergencies ◽  
Altered Physiology

Background: Critically ill obstetric patients pose challenges to the intensive care unit team due to their altered physiology as well as due the presence of the foetus and safety of both the mother and the foetus is of paramount importance.Methods: All antenatal and postnatal cases within 42days of delivery requiring ICU admission from October 2014 to September 2016. Detailed history taken and outcome noted. Results were subjected to statistical evaluation using SSP software.Results: (n=75): obstetric reasons (n=51, 68%) of which 21(28%) had PPH and 17(22.6) had hypertensive disorders of pregnancy. Non-obstetric reasons (n=24, 32%) of which 7(9.3%) cases had jaundice and 4(5.3%) had malaria. Mechanical ventilation was needed in the majority of cases (n=44, 58.7%) followed by inotropic support (n=30, 40%).Maternal mortality was 16%. Mortality was higher (n=8, 66.6%) among patients admitted for obstetric reasons as opposed to non-obstetric indications (n=4, 33.3%).Conclusions: Early detection and prompt referral to the tertiary centre with intensive care facilities should be promoted among the medical fraternity to reduce the incidence of ICU admissions and maternal mortality. All residents of obstetrics and gynaecology should have short mandatory training phase in critical care. Multicentre randomised studies are required for formulating evidence-based national guidelines.

scholarly journals Experiences of the Intensive Care Unit of Hospital Raja PerempuanZainab II in handling the Massive Evacuation of Critically-Ill Patients during Flood Disaster.

2018 ◽  
Vol 2 (4) ◽  
pp. 224
Author(s):  
WI Wan Nasruddin ◽  
ZA Nor Hidayah ◽  
A Nazri ◽  
WI Wan Azzlan ◽  
I Ruwaida ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Life Support ◽  
The State ◽  
Flood Disaster ◽  
Water Levels ◽  
Tertiary Centre ◽  
Set Up

In December 2014, Malaysia had suffered nationwide floods after unprecedented monsoon rains overwhelmed several parts of the country. The East Coast areas of Malaysia were especially badly affected, specifically for the state of Kelantan, whereby a total of 170,000 victims were evacuated to the evacuation centres. This was the worst flood in the last 40 years and has been referred to by the locals as ‘Bah Kuning’. As a tertiary centre for the state of Kelantan with a total number of hospital beds of 937, HRPZ II was also badly compromised during this time. The electricity supply to the main hospital building was shut-down during this period and the hospital had managed to maintain its operations hUP_(ÛT_e power from a generator which had faced the risk of being shut down if the water levels had increased further. These issues might have caused a worse impact viaa possible loss of electrical and oxygen supply and non-functional life support systems. In relation to this flood disaster, the Anaesthesiology and Intensive Care Unit of HRPZ II would like to share the experiences of handling ventilated and critically ill-patients for evacuation during the massive floods in 2014 from the ICU of Hospital Raja Perempuan Zainab II to “an open stage with no facilities”. During this time, we had a total of 19 patients in our 21-bedded Intensive Care Unit. The challenge was the need to evacuate all the critically ill patients and to set-up a new ICU in a safer place immediately at the time.International Journal of Human and Health Sciences Vol. 02 No. 04 October’18. Page : 224-227

scholarly journals A study of clinical characteristics and outcome of obstetric patients in intensive care and high dependency unit of a tertiary centre of Jharkhand, India

2019 ◽  
Vol 9 (1) ◽  
pp. 394
Author(s):  
Samarina Kamal ◽  
Vandita Singh ◽  
Shashibala Singh
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Antenatal Care ◽  
Arterial Embolization ◽  
Postnatal Period ◽  
Primary Objective ◽  
Blood Product Transfusion ◽  
Tertiary Centre ◽  
High Dependency ◽  
A Prospective Study

Background: Few women during their pregnancy, labour and postnatal period require critical care related to the pregnancy itself, aggravation of a pre-existing illness and complications of the delivery. Pregnant patients account for a small number of ICU admission - 2-10% two main indications for admission are hypertensive disorders (17.2%-46%) and massive haemorrhage (10%-32.8%). The primary objective of the present study was to review the characteristics of the obstetric patients admitted to our ICU over a 2-year period.Methods: It was a prospective study conducted over 50 patients in high dependency and intensive care unit at Alam hospital over a period of 2 years (October 2014 to October 2016).Results: During the study period a total of 50 obstetric patients were transferred to the intensive care unit (ICU). Antenatal care played significant role in the obstetric outcome. 84% of patients transferred to the ICU during the study period had inadequate or no antenatal care, while 8% were booked in their pregnancy and had adequate antenatal care. ICU interventions included mechanical ventilation used in 20(40%) patients, blood and blood product transfusion in 35(70%) patients’ inotropes in 20 patients (40%) antihypertensive therapy in 20 patients (40%), arterial embolization in 2(4%) patients. Maternal mortality was seen in 10 patients (20%).Conclusions: There is a need for training in emergency obstetrics so that the complication can be managed right at the time of occurrence.

scholarly journals Obstetric Admissions to the Intensive Care Unit: A 18-Year Review in a Portuguese Tertiary Care Centre

2019 ◽  
Vol 32 (11) ◽  
pp. 693
Author(s):  
Sara Oliveira ◽  
Catarina Filipe ◽  
Natacha Husson ◽  
Isabel Rute Vilhena ◽  
Margarida Anastácio ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Maternal Mortality ◽  
Maternal Morbidity ◽  
Health Care Services ◽  
Hypertensive Disorders Of Pregnancy ◽  
Care Services ◽  
Hypertensive Disorders

Introduction: Maternal mortality and morbidity are important indicators of the quality of health-care services. Obstetric admissions to an intensive care unit may be considered a marker of maternal morbidity. The aim of this study was to determine the incidence, maternal morbidity and mortality of pregnant and postpartum women who required admission to the intensive care unit.Material and Methods: Retrospective analysis of all the obstetric patients admitted to the intensive care unit between 2000 and 2017. Results: Ninety-three women required admission to intensive care (0.7 per 1000 deliveries, 0.8% of all adult admissions). Mean age was 30.3 years, mean gestational age was 33.6 weeks, 51 (54.8%) were primiparous, nine (9.7%) were pregnant of twins and five (5.4%) had not been followed during pregnancy. Eighty-four (90.3%) were admitted after immediate delivery. The most common reasons for admission were hypertensive disorders of pregnancy (35.5%) and obstetric haemorrhage (24.7%). Median length of stay was five days. Transfusion of blood products was needed in 23 (57.0%), artificial ventilation in 50 (53.8%) and use of vasopressors in 21 (22.6%). We observed four maternal deaths (4.3%). Most patients (95.7%) successfully recovered and were transferred to other departments. Sequential Organ Failure Assessment score was significantly associated with maternal mortality.Discussion: Our results are comparable to those obtained in other studies. Maternal mortality was comparable to maternal mortality in developed countries.Conclusion: The incidence of obstetric admissions to the intensive care unit was 0.8% and 0.7 per 1000 deliveries. Hypertensive disorders of pregnancy were the main causes of admission. Maternal mortality was 4.3%. Studies of maternal morbidity are important and can help to improve the quality of health care services.

scholarly journals Creating Successful Emergency Department and Intensive Care Unit Team Dynamics

2020 ◽  
Vol 95 (9) ◽  
pp. S35-S37
Author(s):  
Casey M. Clements ◽  
Richard A. Oeckler ◽  
Heather A. Heaton ◽  
Daniel A. Diedrich ◽  
Daniel R. Brown ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Emergency Department ◽  
Intensive Care ◽  
Team Dynamics ◽  
Intensive Care Unit Team

Maternal mortality in patients admitted to an intensive care unit in Jamaica

2009 ◽  
Vol 105 (2) ◽  
pp. 169-170
Author(s):  
Marinna Scarlett ◽  
Melody-Ann Isaacs ◽  
Sherifa Fredrick-Johnston ◽  
Santosh Kulkarni ◽  
Affette McCaw-Binns ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Maternal Mortality
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