# A study of critically ill obstetric patients admitted to intensive care unit of a tertiary care hospital

## TL;DR

This study examines why and how critically ill pregnant women are admitted to an ICU in Pakistan and finds that complications like kidney failure and DIC are linked to higher mortality.

## Contribution

The study identifies key factors affecting mortality in critically ill obstetric patients in a Pakistani hospital setting.

## Key findings

- Pre-eclampsia and eclampsia were the most common reasons for ICU admission.
- Postpartum hemorrhage had the highest case fatality rate among ICU-admitted patients.
- Complications like acute renal failure and DIC were strongly associated with mortality.

## Abstract

To evaluate characteristics, indications, complications and outcome of obstetric patients admitted to ICU of tertiary care hospital in KPK, Pakistan.

This descriptive study was conducted in department of OBGYN of Lady Reading Hospital, Peshawar from January 2021 till December 2021. A total of 62 patients were enrolled into the study using nonprobability consecutive sampling technique. Their data were collected on a proforma. All patients were followed till their death or discharge home from hospital.

The mean duration of ICU stay of patients, was 6.85 ± 4.82 days. Out of 62 patients 17 (27.41%) expired in ICU, while 45 (72.58%) patients survived and were discharged. Pre-eclampsia and Eclampsia was the commonest primary diagnosis, accounting for 28 cases (45.2%) with a case fatality rate of 25%, followed by 13 cases (21%) of primary postpartum hemorrhage (PPH) as the second commonest reason for ICU admission and a case fatality rate of 38%. The underlying primary diagnosis had no statistically significant association with outcome of the patient. Acute Renal failure had statistically significant association with outcome of the patient with adjusted OR 4.79, CI:1.17-19.66, p-0.02. Similar positive association with mortality existed for patients having DIC (aOR:6.59; CI:1.34-32.34, p-0.02).

Pre-eclampsia/Eclampsia is the commonest reason for intensive care admission, however PPH has the highest case fatality rate. The outcome of critically ill obstetric patients is dependent on complications and not primary underlying diagnosis.