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Clinical and Experimental Obstetrics & Gynecology  2021, Vol. 48 Issue (1): 117-121    DOI: 10.31083/j.ceog.2021.01.2124
Original Research Previous articles | Next articles
Clinical characteristics and outcomes of obstetric patients requiring ICU admission: a 5-year retrospective review
Min Zhang1, Zhan-Hong Tang1, Han-Chun Wen1, Ying-Lin Wu1, Xing-Xin Gao2, *()
1Department of Critical Care Medicine, First Affiliated Hospital of Guangxi Medical University, Nanning, 530021 Guangxi, P. R. China
2Department of Burns and Plastic, First Affiliated Hospital of Guangxi Medical University, Nanning, 530021 Guangxi, P. R. China
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Abstract  
Objective: To investigate the clinical characteristics and outcomes of obstetric patients requiring intensive care unit (ICU) admission in a tertiary hospital. Methods: We retrospectively analyzed the clinical data of all pregnant/postpartum patients admitted to a tertiary ICU from January 2014 to December 2018. Result: One hundred and thirty-three obstetric patients were analyzed. Most patients (114, 85.7%) were admitted postpartum, and 57.9% (n = 77) of ICU admissions were from obstetric causes. The most common obstetric cause of admission was obstetric hemorrhage (32, 24.1%), followed by pregnancy-associated hypertension (25, 18.8%). The most common non-obstetric cause of admission was cardiac disorder (16, 12%). Ninety-eight patients (73.7%) came from non-urban areas. We compared patients from non-urban areas versus urban areas: Acute Physiology and Chronic Health Evaluation (APACHE) II, 8.35 ± 3.14 versus 6.43 ± 2.59 (P = 0.002); standard prenatal care, 62.3% versus 90.3% (P = 0.004); transferred from another hospital, 25.5% versus 2.9% (P = 0.004); blood transfusion, 48% versus 22.9% (P = 0.010); plasmapheresis, 11.2% versus 0% (P = 0.039); multiple-organ dysfunction syndrome, 30.6% versus 11.4% (P = 0.026); mortality, 10.2% versus 2.9% (P = 0.176). Total maternal mortality in ICU was 8.3% (n = 11). The fetal mortality rate was 10.9% (n = 15). Conclusions: A multidisciplinary team approach is essential to improve the management of obstetric hemorrhage, hypertensive disorders and cardiac disorders, which may in turn significantly improve maternal outcomes. Health disparities existed between patients from non-urban versus urban areas: the former was sicker at admission, received less standard prenatal care, were more frequently transferred from other hospitals, received more interventions, developed more complication, and suffered a higher rate of maternal mortality.
Key words:  Intensive care      Maternal mortality      Obstetrics      Urban areas      Non-urban     
Submitted:  29 April 2020      Revised:  09 August 2020      Accepted:  15 August 2020      Published:  15 February 2021     
Fund: 2017GXNSFAA198045/Natural Science Foundation of Guangxi Province
*Corresponding Author(s):  Xing-Xin Gao     E-mail:  11500315@163.com

Cite this article: 

Min Zhang, Zhan-Hong Tang, Han-Chun Wen, Ying-Lin Wu, Xing-Xin Gao. Clinical characteristics and outcomes of obstetric patients requiring ICU admission: a 5-year retrospective review. Clinical and Experimental Obstetrics & Gynecology, 2021, 48(1): 117-121.

URL: 

https://ceog.imrpress.com/EN/10.31083/j.ceog.2021.01.2124     OR     https://ceog.imrpress.com/EN/Y2021/V48/I1/117

[1] J. Jin, J. Tang. Clinical application and economics of five short-acting combined oral contraceptives over five years of obstetrics and gynecology practice in China based on real-world study[J]. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(6): 940-949.
[2] T. Hasegawa, K. Nakagawa, R. Sugiyama, N. Kuji, H. Nishi. Separate transfer of two frozen-thawed embryos reduces multiple gestations in assisted reproductive technology[J]. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(2): 215-219.
[3] J. Huang, Z. Zhang. Spontaneous umbilical cord vascular rupture before labor for congenital defects with a live birth: a case report[J]. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(1): 142-143.
[4] Erqiu Du, Yongmei Li, Li Shang, Yongli Chen, Xia Gao, Xueying Duan. Uterine rupture in twin pregnancy complicated with herniation of amniotic sac and umbilical cord: a case report[J]. Clinical and Experimental Obstetrics & Gynecology, 2019, 46(2): 333-334.
[5] A. Simsek, S. Uludag, A. Tuten, A. S. Acikgoz, S. Uludag. Maternal and perinatal outcomes in early onset and late onset preeclampsia[J]. Clinical and Experimental Obstetrics & Gynecology, 2018, 45(6): 837-841.
[6] M. Daglas, V. Petousi. Ethical decision making in neonatal intensive care: adaptation of EURONIC research protocol in Greece[J]. Clinical and Experimental Obstetrics & Gynecology, 2018, 45(2): 237-244.
[7] W.Y. Gong, Y.P. Li, C.T. Zuo, X.T. Wang. Clinical characteristics and pregnancy outcomes in parturients with pulmonary hypertension: experience with 39 consecutive cases from China[J]. Clinical and Experimental Obstetrics & Gynecology, 2018, 45(2): 257-261.
[8] B. Kaya, B. Karamustafaoglu Balci, K. Daglar, M. Polat, A. Tuten, H. Sahin, A. Soliman, O. Guralp. Surgical treatment of uterine atony: an assessment of final year obstetrics and gynecology residents in Turkey with a questionnaire[J]. Clinical and Experimental Obstetrics & Gynecology, 2017, 44(6): 899-904.
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