Epidemiology of obstetric critical illness |
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| Affiliation: | 1. Intensive Care Unit, Shaare Zedek Medical Center and Hebrew University School of Medicine, Jerusalem, Israel;2. Department of Anesthesiology and Intensive Care Medicine, Hôpital Nord, Assistance Publique Hôpitaux de Marseille, Aix Marseille University, Marseille, France;1. Department of Anesthesiology, Pain and Perioperative Medicine, Icahn School of Medicine at Mount Sinai, USA;2. Department of Anesthesiology, Pain and Perioperative Medicine, Department of Obstetrics, Genecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, USA;1. Perioperative Research Group, Department of Anaesthetics, Critical Care and Pain Management, University of KwaZulu-Natal, Pietermaritzburg, South Africa;2. Department of Anaesthesia and Perioperative Medicine, Groote Schuur Hospital, Faculty of Health Sciences, University of Cape Town, South Africa;1. Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA;2. Department of Anesthesiology, Duke University School of Medicine, Durham, NC, USA;1. Department of Anesthesiology, Baylor College of Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA;2. Kamuzu Central Hospital, Lilongwe, Malawi;3. Department of Obstetrics & Gynecology, Baylor College of Medicine, Houston, TX, USA;4. Dept. of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA;1. Tampere University, Faculty of Social Sciences, Finland;2. Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland;3. Centre for Research Methods, Faculty of Social Sciences, University of Helsinki, Finland;4. Tampere University and Tampere University Hospital, Finland;5. Tampere University Hospital and Faculty of Social Sciences, Tampere University, Finland;1. Department of Obstetrics and Gynaecology, University of Benin Teaching Hospital, Benin City, Nigeria;2. Department of Anaesthesia, University of Benin Teaching Hospital, Benin City, Nigeria |
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| Abstract: | Obstetric intensive care unit (ICU) admissions comprise only a small part of severe maternal morbidity. The incidence rate of both remains relatively unclear due to inconsistent definitions across publications, although this has begun to be addressed. There is a relative paucity of information regarding disease-specific survival following obstetric ICU admission, but outcomes are clearly related to the cause of admission and the quality of care. The ratio between maternal near-miss cases (many of whom are admitted to ICUs) and maternal death may provide insight into the preventability of death.Hemorrhage and pre-eclampsia constitute the leading causes of ICU admission and have relatively low mortality rates, perhaps demonstrating the impact of informed care in managing obstetric critical illness. Obstetric sepsis, heart disease and anesthesia complications should be the focus of future research. The incidence of obstetric sepsis has been increasing in the last decade, with mortality rates remaining relatively high. The incidence of obstetric heart disease is increasing and maternal complications have been attributed to fractionated care of mothers within this category. Anesthesia complications remain a predominant cause of maternal death and likely intensive care admission.Data are lacking regarding the relative proportion of cases per disease that remain treated outside the ICU; and the outcomes of various management strategies. The only study of the health status of survivors of obstetric ICU admission revealed that six months after hospital discharge, one in five women still had a poorer health-related quality of life than those of a reference age- and sex-matched cohort. |
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| Keywords: | Pregnancy complications Pregnancy Peripartum Critical care Critical illness Epidemiology |
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