Soins maternels intensifs (Maternal Intensive Care) en Belgique - KCE

Meerman,
R.H., Harinck,
B.I.J., Feuth,
H.D.M. & van
Roosmalen, J.
(2006)
Zeeman, G.
(2006)
106 Maternal Intensive Care in Belgium KCE Reports 94
4 The
Netherlands
Leiden University
Medical Centre
(1991-2001)
of all obstetric admissions to the
multidisciplinary ICU 1990-2001.
Post-operative recovery women
were excluded. Data on: diagnosis
at the time of ICU admission,
therapeutic interventions, maternal
outcome, perinatal mortality and
length of ICU and hospital stay.
Special attention was given to the
relation between ICU admission
and ethnic background (Caucasian
or not-Caucasian).
Focuses on several important
disorders of critically ill obstetric
patients and reviews issues of
respiratory failure in pregnancy.
/ Literature review of 30 articles
(last 15 years) describing
characteristics and treatment of
critically ill pregnant or puerperal
women. Items like the lack of ICU
scoring systems for critically ill
obstetric patients, obstetric highdependency
care unit (and the
indications for intermediate and
ICU-care), maternal morbidity as
indicator for quality of care,
preeclampsia, hemorrhage and who
cares for the critically ill obstetric
patient are discussed.
based analysis of
medical records of
all obstetric
admissions ICU
(syst.) literature
review
Intensive Care Unit (ICU) during pregnancy,
childbirth or puerperium.
RESULTS: Over these 12 years, 142
women required ICU admission (0.76% of all
deliveries, 0.70% of all adult ICU admissions).
The most common reasons for ICU
admission were (pre)eclampsia (62.0%) and
obstetric haemorrhage (18.3%). Twentyseven
out of 142 women (19.0%) were of
non-caucasian origin. The most common
therapeutic interventions were transfusion of
erythrocytes (66.2%), caesarean section
(50.7%) and artificial ventilation (44.4%). We
observed seven maternal deaths (4.9%).
CONCLUSION: We need better
information about high-risk obstetric patients
in order to prevent severe maternal
morbidity and to improve maternal care. The
high number of non-caucasian women
requiring ICU admission indicates the need
for a study into the role of ethnicity. We
have initiated a nationwide confidential
enquiry into the causes of severe maternal
morbidity.
OBJECTIVE: The purpose of this review is
two-fold: first, to provide an update on
currently available reports pertaining to
important critical care issues of the obstetric
patient population and, second, to present
current comprehensive treatment options
for preeclampsia and massive obstetric
hemorrhage because both are responsible
for the majority of maternal mortality and
morbidity worldwide.
RESULTS: The most common reasons for
intensive care unit admission are
hypertensive disorders and massive obstetric
hemorrhage. Timely delivery and prompt
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Score:
twijfel-achtig
3