Obstetric patients requiring critical care: Retrospective study in a tertiary care institute of Pakistan

Background: The outcome of obstetric patients admitted to the intensive care unit (ICU) depends on the number of factors. The objective of this study is to review the outcomes of these patients with regard to pregnancy status, source of admission, and their presenting illness at time of admission to ICU. Materials and Methods: A retrospective study was undertaken for all obstetric patients admitted to the ICU of a private tertiary care hospital of Pakistan from 2014 to 2018. The data were reviewed thorough ICU log sheet, electronic medical records, and online laboratory data. The data included patient demographics, pregnancy status, mode of admission, length of stay, laboratory investigation, presenting disease, and outcomes in terms of death or survival. Results: Obstetric patients accounted for 3.8% for all ICU admission with overall mortality of 11.1%. There was no statistically significant difference in the mortality rate with respect to presenting illness; however, morality was highest (37.5%) in patients with pre-eclampsia. A majority (54.2%) of the ICU admission were due to hemorrhagic/hematological causes followed by cardiovascular causes (33.1%). A statistically significant increase in mortality rate was observed in patients admitted through emergency compared with patients from within hospital (P < 0.0005). Conclusion: Patients coming through emergency as referral patients were found to have the highest mortality. There is dire need to uplift the primary and secondary tertiary care centers in developing countries, where early treatment can be provided and high-risk cases can be picked up with early referral to tertiary care center.