# Severe Maternal Outcome in Women Admitted to an Obstetric Intensive Care Unit in the Northeast of Brazil: A Cross-Sectional Study

## TL;DR

This study examines the causes and outcomes of severe maternal complications in a Brazilian obstetric ICU, finding that infections and other direct obstetric issues are major contributors.

## Contribution

The study identifies puerperal infection as the most significant factor associated with severe maternal outcomes in a specific Brazilian region.

## Key findings

- 48.5% of women admitted to the ICU experienced severe maternal outcomes.
- Puerperal infection was most strongly associated with severe maternal outcomes.
- Hypertensive syndromes and postpartum haemorrhage were also major causes of severe maternal outcomes.

## Abstract

Objective: The objective of this study is to describe the characteristics of women who experienced severe maternal outcomes (SMO: maternal near-miss or maternal death) in an obstetric intensive care unit (ICU).

Methods: A cross-sectional study was carried out including pregnant or postpartum women up to 42 days of childbirth admitted to the obstetric ICU at one reference centre in the northeast of Brazil, for any clinical, surgical, or obstetric complication, with data collected between October 29, 2018, and September 30, 2019. Maternal characteristics, details on admission to the ICU, pregnancy outcomes, and causes for ICU admission were compared between groups with SMO or with the remaining group, potential life-threatening conditions (PLTCs). A significance level of 5% was adopted.

Results: During the study period, 309 women were admitted to the obstetric ICU and considered eligible for the study. SMO was observed in 150 (48.5%) of these women. Of these, 8 (2.6%) were maternal deaths, and 142 (45.9%) presented one or more near-miss criteria. Most women with a SMO were admitted for direct obstetric causes such as hypertensive syndromes, postpartum haemorrhage, or puerperal infection. SMO was associated more frequently with puerperal infection.

Conclusion: SMO is a commonly occurring outcome in an obstetric ICU with great possibility of treatment. Direct obstetric causes such as hypertension syndromes, postpartum haemorrhage, and puerperal infection were the most prevalent causes in the development of this outcome. Puerperal infection was the condition most associated with SMO.