Roohina Baloch, Nasir Khan Jakhrani, Erum Zeb, Sumaiyya Hafeez, Mehnaz Abassi, Farah Naz Abbasi.
Pattern and outcome of obstetric admissions to the surgical intensive care unit - a ten years study.
J Surg Pak Jan ;15(4):171-6.

Objective To identify characteristics, indications for admission, interventions and outcome of critically ill obstetric patients admitted to the Surgical Intensive Care Unit (SICU). Study design Retrospective descriptive study. Place & Duration of study Surgical Intensive Care Unit (SICU) of Jinnah Postgraduate Medical Centre, Karachi, from February 2000 to January 2010. Methodology The data of consecutive obstetric patients admitted to SICU was reviewed. The characteristics, indications for admission, intervention and outcome were assessed. The data related to demographics, obstetric history, pre-existing medical problems, indications for SICU admission, intervention required, length of stay and outcome of SICU admission were collected by retrospective review of medical records. Statistical analysis was done using SPSS software. Results A total of 152 obstetric patients required SICU admission. The total number of admissions into Surgical Intensive Care Unit was 152/4500 for ten years. This accounts for 3.4% of all SICU admissions. Most patients were young (median age of 28.5 years ±6.1) and stayed in SICU for an average of 4.61 days. Fifty-eight (38.2%) patients were admitted because of haemorrhagic disorders including postpartum haemorrhage – PPH (17.76%), antepartum haemorrhage – APH (7.89%), ruptured uterus (12.5%), ruptured ectopic pregnancy (1.32%). The hypertensive disorder of pregnancy was found in 55 (36.2%) patients including pregnancy induced hypertension – PIH (34.21%), eclampsia (26.9%), severe pre-eclampsia (4.61%), HELLP syndrome (5.26%), and cerebrovascular accident – CVA (3.29%). Ventilatory support was required in 88.16% (n 134) patients. In majority of patients, direct arterial (88.82%) and central venous pressure monitoring (68.42%) was carried out. Ionotropic support was given to 50% of patients. Conclusions The two most common indications were obstetric haemorrhages and hypertensive disorders of pregnancy. Appropriate antenatal care is important in preventing obstetric complications.

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