A PROSPECTIVE STUDY OF THE CLINICAL PROFILE AND OUTCOMES OF HYPERTENSIVE DISORDERS OF PREGNANCY (HDsP) ADMITTED TO A MULTIDISCIPLINARY ICU

BACKGROUND Hypertensive disorders of pregnancy (HDsP) are associated with significant mortality and morbidity of the pregnant patient with wide variations between developed and developing countries. In the present study, we aim to evaluate the magnitude, complications, mortality, and morbidity of patients with HDsP who were admitted to a multidisciplinary intensive care unit (ICU) of a tertiary hospital. METHODS We conducted a prospective observational study for two years on all obstetric patients with HDsP shifted to the multidisciplinary ICU of a tertiary care hospital. Demographic profile prevalence of various hypertensive disorders, associated complications, interventions and outcomes were analysed. RESULTS Forty-one patients were admitted to the ICU with hypertension complicating pregnancy and carried an ICU mortality rate of 7.3% (n=3). The mean age of the study group was 31.22 +/- 6.5 years. Majority of them were primigravidae (59%), in their third trimester (53.7%) and received antenatal care (85.3%). Preeclampsia (n=19) and eclampsia (n=13) accounted for 79% of admission to ICU. Most of them were shifted to ICU during the postpartum period (93%) and 58.6% underwent caesarean section. Haemolysis, Elevated Liver Enzymes, and Low Platelet syndrome (19.5%), Posterior Reversible Encephalopathy syndrome (31.7%) and acute renal failure (22%) were common among the complications. Sequential Organ Failure Assessment score (SOFA) were significantly high among the non survivors indicating multiple organ system involvement. CONCLUSIONS Hypertensive disorders of pregnancy remain the most common cause of admission to ICU among the critically ill obstetric patients causing significant mortality and morbidity.