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

Umo-Etuk, J.,
Lumley, J. &
Holdcroft, A.
(1996)
Wheatley, E.,
Farkas, A. &
Watson, D. (1996)
116 Maternal Intensive Care in Belgium KCE Reports 94
2 UK 43 ICU
admissions
3 UK 122 women
admitted to
an ITU
Retrospective analysis of medical
records from parturient women
admitted to the ICU of the
Hammersmith Hospital, from 1989 to
1994. Patient’s data were accepted
for the study if 1. the admission was a
direct result of pregnancy and its
complications, 2. ICU admission
occurred in the presence of a
coincidental pregnancy, or 3. ICU
admission was initiated by a medical
problem which could have been
aggravated by the physiological
changes of pregnancy. Data collected
included the patient’s demographic
details (age, gestational age, parity),
past medical and obstetric history,
ICU management (duration of 80
admission, use of invasive monitoring
and inotropes, blood transfusion and
special interventions), complications
developing in the ICU and outcome
(mortality, place of discharge).
Retrospective analysis of the notes of
obstetric patients admitted to an
tertiary ITU at Homerton Hospital
from 1989 to 1993. Relevant clinical
data were abstracted for mother and
baby. Indications for ITU admission,
Retrospective
tertiary
centre based
analysis of
medical
records of
parturient
women
admitted to
the ICU
Retrospective
tertiary
centre based
analysis of
notes of
obstetric
OBJECTIVE: To compliment the report on
Confidential Enquiries into Maternal Deaths, an analysis
of 5 years of obstetric data from a UK ICU was
considered appropriate.
RESULTS: Thirty-nine parturient women were
admitted to a general intensive care unit (ICU) from
April 1989 to March 1994 and of these four were
readmitted (total 43 admissions). Twelve women were
admitted to the obstetric unit from peripheral hospitals
in different regions, but no requirement for intensive
care was perceived on referral. Six women were
transferred directly into the intensive care unit from
different hospitals in the region. The incidence of
obstetric patients requiring ICU admission, excluding
direct transfers, was 0.64%. The majority (85%) were
postpartum, and 64% were primiparous. Morbidity was
caused primarily by hypertensive disorders (33%) and
haemorrhage (33%). The remainder included medical
disorders (21%), sepsis (13%) and surgical problems
(5%). Associated major complications were acute renal
failure, coagulopathies and adult respiratory distress
syndrome. A multidisciplinary approach to management
is practised and specialist interventions included
haemofiltration and haemodialysis (18%) and radiological
arterial embolisation (10%). Ventilatory and inotropic
support were given in 38% and 41% of patients
respectively. Only one patient died on the intensive care
unit, this was from multiorgan failure secondary to
sepsis.
CONCLUSION: ?
OBJECTIVE: Complications of pregnancy may
necessitate admission to an Intensive Therapy Unit
(ITU). All obstetric patients admitted to ITU were
reviewed in order to assess whether these admissions
could have been
predicted and to determine the place of intensive care
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