Admission profile in an obstetrics intensive care unit in a maternity hospital of Brazil

Melania Maria Ramos de Amorim Leila Katz Marina Brito Ávila Daniella Ericson Araújo Mariana Valença Carlos Japhet da Mata Albuquerque Ana Rita Marinho Ribeiro Carvalho Alex Sandro Rolland de Souza About the authors

OBJECTIVES: to describe a three-year experience with obstetric Intensive Care Units (ICU), a unit allowing obstetricians to continue to care for critically ill obstetrics patients. METHODS: the study evaluated all admissions (933) to the Obstetric ICU, in the Instituto Materno Infantil Prof. Fernando Figueira (IMIP), from September 2002 to February 2005. Age, parity, diagnosis, admission time, diagnosis during ICU stay, associated complications, invasive procedures utilized, and final outcome were analyzed. RESULTS: hypertension (87%), obstetric hemorrhage (4.9%) and obstetric infection (2.1%) were the major cause of the admissions analyzed. Mean age was 25 years, 65% of the patients delivered by cesarean-section. Anemia was a very common finding (58.4%). Other diagnoses were renal insufficiency, thromboembolic disease, cardiac disease, acute pulmonary edema, sepsis, and hemorrhagic shock. Of the 814 patients with pregnancy-associated hypertension 65% had severe pre-ecclampsia, 16% mild pre-ecclampsia, and 11% ecclampsia. HELLP syndrome was found in 46%. Mechanical ventilation was necessary in 3.6% and hemotransfusion in 17% of the patients. Mean stay was five day (1 a 41) days. Death occurred in 2.4% of the patients. CONCLUSIONS: the rate of deaths was low. An obstetric ICU managed by obstetricians could be a feasible way of dealing with maternal mortality.

Intensive care unit; Obstetrics; Pregnancy; Hypertension; Critical care

Instituto de Medicina Integral Prof. Fernando Figueira Rua dos Coelhos, 300. Boa Vista, 50070-550 Recife PE Brasil, Tel./Fax: +55 81 2122-4141 - Recife - PR - Brazil