2012, Number 2
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Revista Cubana de Obstetricia y Ginecología 2012; 38 (2)
Characterization of the severe mother morbility in an Intensive Care Unit
Acevedo RO, Sáez CV, Pérez AA, Alcina PS
Language: Spanish
References: 27
Page:
PDF size: 113.71 Kb.
ABSTRACT
Introduction: the admission in the intensive care unit is a marker of extremely severe maternal mortality and an important tool to reduce the morbidity and mortality in obstetric patients with complications.
Objectives: to characterize the maternal morbidity in an intensive care unit related to the admission causes.
Methods: a retrospective study was conducted in 212 mothers admitted in the intensive care unit (icu) of the "enrique cabrera: hospital, habana, 2008-2009. data wer4 collected from medical records, the admission diagnosis was taken as the dependent variable. for qualitative variables authors used percentages and chi2-test and for the quantitative ones the t-test, using the statistic spss-11.5 system.
Results: there were admitted 133 patients (62.7 %) by non-obstetric causes and 79 (36.3 %) by obstetric causes where these last ones included hypertensive disorders (16.5 %), obstetric hemorrhage (14.2 %) and sepsis (6.1 %) and the more frequent non-obstetric ones included respiratory disorders (19.8 %), a complicated postoperative period (9 %) and cardiovascular disorders (5.7 %). From the total of patients, the 49.6 % was 20-24 years old. In the non-obstetric admissions there was predominance of nullipara for a 24.5 % and the pregnants, 40.6 % vs 21 %. but in the obstetric ones prevailed the puerperants ones, 33 % vs 1.9 % (p= 0.000). The 37.3 % of non-obstetric admissions had chronic diseases vs 9.9 % (p= 0.000). The 23.1 % of patients had complications greater in non-obstetric admissions, 14.6 % vs 8.5 % (p= 0.000). Ventilation rate was of 6.1 % and the general stay was of 4.8 ± 4.4 days.
Conclusions: there was predominance of admissions by non-obstetric causes and in the postpartum. Admission by obstetric causes had more complications.
REFERENCES
Mantel GD, Buchmann E, Rees H, Pattinson RC. Severe acute maternal morbidity: a pilot study of a definition for near miss. Br J Obstet Gynaecol 1998, 105:985-90.
Selo-Ojeme DO, Omosaiye M, Battacharjee P, Kadir RA. Risk factors for obstetric admissions to the intensive care unit in a tertiary hospital: a case-control study. Arch Gynecol Obstet. 2005;272:207-10. Disponible en: http://www.ajol.info/index.php/ajrh/article/view/74792/65395
Pérez Assef A. Incidencia y pronóstico del Síndrome de Disfunción Multiorgánica en pacientes obstétricas ingresadas en cuidados intensivos. Rev Cub Med Int Emerg. 2004;3(2):5-11.
Cheng C, Raman S. Intensive care use by critically ill obstetric patients: a five year review. Int J Obstetric patients: a five year review. Int J Obstet Anesth. 2003;12(2):89-92.
Demirkiran O, Dikmen Y, Utka T, Urkmez S. Critically ill obstetric patients in the intensive care unit. Int J Obstet Anesth. 2003;12(4):266-70.
Pérez Assef, Bacallao Gallestey J, Alcina Pereira S, Gómez Vazco Y. Severe Maternal Morbidity in the Intensive Care Unit of Havana Teaching Hospital, 1998 to 2004. MEDICC review. Summer. 2008;10(3):17-23.
Cabezas Cruz E. Evolución de la mortalidad materna en Cuba. Rev Cubana Salud Pública. 2006;32(1). Disponible en: http://scielo.sld.cu/pdf/rcsp/v32n1/spu05106.pdf
Vasquez D, Estenssoro E, Canales HS, Reina R, Sáenz MG, Das Neves AV, et al. Clinical Characteristic and outcomes of obstetric patients requiring ICU admission. Chest. 2007;131:718-24.
Al-Suleiman SA, Qutub HO, Rahman J, Rahman MS. Obstetric admissions to the intensive care unit: a 12-year review. Arch Gynecol Obstet. 2006;274:4-8. Disponible en: http://www.portalesmedicos.com/publicaciones/search
Loverro G, Pansini V, Greco P, Vimercati A, Parisi AM, Selvaggi L. Indications and outcome for intensive care unit admission during puerperium. Arch Gynecol Obstet. 2001;265:195-8. Disponible en: http://www.springerlink.com/content/qcvn918uyjfer0ec/
Afessa B, Green B, Delke I, Koch K. Systemic Inflammatory response syndrome, organ failure and outcome in critically ill obstetric patients treated in an ICU. Chest. 2001;120(40):1271-7.
Okafor UV, Aniebue U. Admission pattern and outcome in critical care obstetric patients. Int J Obstet Anesth. 2004;13(3):164-6.
Kamad DR, Lapsiam V, Krishnan A, Salvi VS. Prognostic factors in obstetric patients admitted to an Indian intensive care unit. Crit Care Med. 2004;32:1418-9.
Ramos de Amorim M, Katz L, Brito AM, Ericson AD, Valença M, Da Mata AC, et al. Perfil das Admissões em uma unidade de terapia intensiva obstétrica de uma maternidade brasileira. Rev. Bras. Saúde Matern. Infant. Recife. 2006;6(1):555-62.
Urbay RA, Cruz MH, Fong SJ, Santos PL, Valledor TR, Molerio SL. Comportamiento de la enfermedad obstétrica grave. Nueve años en una unidad de cuidados intensivos. Medicentro. 2002;6(2).
Díaz Mayo J, Pérez Assef A, Hernández Berigestain JD, Naranjo IS. Morbimortalidad materna en la unidad de cuidados intensivos del hospital general docente Enrique Cabrera. Disponible en: http://www.sld.cu/galerias/pdf/sitios/urgencia/117_-_morbimortalidad_materna_en_la_unidad_de_cuidados_intensivos_del_hospital_general_docente_enrique_cabrera.pdf
Rodríguez IG, Delgado CJ, Pérez RL. Experiencia de 12 años de trabajo en la atención de adolescentes obstétricas críticamente enfermas en la unidad de cuidados intensivos. Rev Cubana Obstet Ginecol. 1999;25(3):141-5.
Pérez Assef A, Calixto AD, Tamayo GF, Hernández BJ. Evaluación de la mortalidad materna en cuidados intensivos con una escala pronóstica. Disponible en: http://www.sld.cu/galerias/pdf/sitios/urgencia/041_-_evaluacion_de_la_mortalidad_materna_en_cuidados_intensivos_con_una_escala_pronostica.pdf
Collop NA, Sahn SA. Critical Illness in pregnancy: An analysis of 20 patients admitted to a medical Intensive care unit. Chest. 1993;103;1548-52.
Osinaike BB, Amanor-Boadu SD, Sanusi AA. Obstetric Intensive Care: A Developing Country Experience, Internet Journal of Anesthesiology. 2006; 10(2). Disponible en: http://web.ebscohost.com/ehost/detail?vid=5&hid=9&sid=cfacceec-a501-4909-874f -8a93132dccd8%40sessionmgr4&bdata=JmxvZ2lucGFnZT1Mb2dpbi5hc3AmYW1wO2xhbmc9ZXMmc2l0ZT1laG9zdC1saXZl#db=aph&AN=24182639
Zwart JJ, Dupuis JRO, Richters A, Ory F, Van Roosmalen J. Obstetric intensive care unit admission: a 2-year nationwide population-based cohort study. Intensive Care Med. 2010;36:256-63. Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2809313/pdf/134_2009_Article_1707.pdf?tool=pmcentrez
Braga Viggiano M, Campos Viggiano MG, De Souza E, Camano L. Necessidade de Cuidados Intensivos em Maternidade Pública Terciária. RGBO. 2004;26(4):317-23.
Olarra J, Longarela AM, Suárez L, Palacio FJ. Critical ill obstetric patients treated in an ICU. Chest. 2002;121:2077. Disponible en: http://bvs.sld.cu/revistas/gin/vol35_4_09/gin03409.htm
Munnur U, Karnad DR, Bandi VD, Lapsia V, Zurres MS, Ramshesh P, et al. Critically ill obstetric patients in an American and an Indian public hospital: comparison of case-mix, organ dysfunction, intensive care requirements, and outcomes. Intensive Care Med. 2005;31:1087-94. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/16012807
Cabezas Cruz E. Mortalidad materna y perinatal en adolescentes. Rev Cubana Obstet Ginecol. 2002;28(1):5-10. Disponible en: http://scielo.sld.cu/pdf/gin/v28n1/gin01102.pdf
Kilpatrick SJ, Matthay MA. Obstetric patients requiring critical care. A five-years review. Chest. 1992;101;1407-12.
Baskett TF, O'Connell CM. Severe obstetric maternal morbidity: a 15-year population-based study. Journal of Obstetrics and Gynaecology. January 2005; 25(1):7-9. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/16147683