Obstetric Admissions to the Intensive Care Unit: A 18-Year Review in a Portuguese Tertiary Care Centre

Detalhes bibliográficos
Autor(a) principal: Oliveira, Sara
Data de Publicação: 2019
Outros Autores: Filipe, Catarina, Husson, Natacha, Vilhena, Isabel Rute, Anastácio, Margarida, Miranda, Marisa, Devesa, Nuno
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11410
Resumo: Introduction: Maternal mortality and morbidity are important indicators of the quality of health-care services. Obstetric admissions to an intensive care unit may be considered a marker of maternal morbidity. The aim of this study was to determine the incidence, maternal morbidity and mortality of pregnant and postpartum women who required admission to the intensive care unit.Material and Methods: Retrospective analysis of all the obstetric patients admitted to the intensive care unit between 2000 and 2017. Results: Ninety-three women required admission to intensive care (0.7 per 1000 deliveries, 0.8% of all adult admissions). Mean age was 30.3 years, mean gestational age was 33.6 weeks, 51 (54.8%) were primiparous, nine (9.7%) were pregnant of twins and five (5.4%) had not been followed during pregnancy. Eighty-four (90.3%) were admitted after immediate delivery. The most common reasons for admission were hypertensive disorders of pregnancy (35.5%) and obstetric haemorrhage (24.7%). Median length of stay was five days. Transfusion of blood products was needed in 23 (57.0%), artificial ventilation in 50 (53.8%) and use of vasopressors in 21 (22.6%). We observed four maternal deaths (4.3%). Most patients (95.7%) successfully recovered and were transferred to other departments. Sequential Organ Failure Assessment score was significantly associated with maternal mortality.Discussion: Our results are comparable to those obtained in other studies. Maternal mortality was comparable to maternal mortality in developed countries.Conclusion: The incidence of obstetric admissions to the intensive care unit was 0.8% and 0.7 per 1000 deliveries. Hypertensive disorders of pregnancy were the main causes of admission. Maternal mortality was 4.3%. Studies of maternal morbidity are important and can help to improve the quality of health care services.
id RCAP_639c6af83916aa5f7715dd60bb7766f6
oai_identifier_str oai:ojs.www.actamedicaportuguesa.com:article/11410
network_acronym_str RCAP
network_name_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository_id_str 7160
spelling Obstetric Admissions to the Intensive Care Unit: A 18-Year Review in a Portuguese Tertiary Care CentreAdmissões Obstétricas em Unidade de Cuidados Intensivos: Uma Revisão de 18 Anos num Hospital Terciário PortuguêsIntensive Care UnitsMaternal MortalityPregnancyPregnancy ComplicationsComplicações na GravidezGravidezMortalidade MaternaUnidades de Cuidados IntensivosIntroduction: Maternal mortality and morbidity are important indicators of the quality of health-care services. Obstetric admissions to an intensive care unit may be considered a marker of maternal morbidity. The aim of this study was to determine the incidence, maternal morbidity and mortality of pregnant and postpartum women who required admission to the intensive care unit.Material and Methods: Retrospective analysis of all the obstetric patients admitted to the intensive care unit between 2000 and 2017. Results: Ninety-three women required admission to intensive care (0.7 per 1000 deliveries, 0.8% of all adult admissions). Mean age was 30.3 years, mean gestational age was 33.6 weeks, 51 (54.8%) were primiparous, nine (9.7%) were pregnant of twins and five (5.4%) had not been followed during pregnancy. Eighty-four (90.3%) were admitted after immediate delivery. The most common reasons for admission were hypertensive disorders of pregnancy (35.5%) and obstetric haemorrhage (24.7%). Median length of stay was five days. Transfusion of blood products was needed in 23 (57.0%), artificial ventilation in 50 (53.8%) and use of vasopressors in 21 (22.6%). We observed four maternal deaths (4.3%). Most patients (95.7%) successfully recovered and were transferred to other departments. Sequential Organ Failure Assessment score was significantly associated with maternal mortality.Discussion: Our results are comparable to those obtained in other studies. Maternal mortality was comparable to maternal mortality in developed countries.Conclusion: The incidence of obstetric admissions to the intensive care unit was 0.8% and 0.7 per 1000 deliveries. Hypertensive disorders of pregnancy were the main causes of admission. Maternal mortality was 4.3%. Studies of maternal morbidity are important and can help to improve the quality of health care services.Introdução: Mortalidade e morbilidade maternas são importantes indicadores da qualidade dos cuidados de saúde. As admissões obstétricas numa unidade de cuidados Intensivos podem ser consideradas um marcador de morbilidade materna. O objetivo deste estudo foi determinar a incidência, morbilidade e mortalidade maternas das gestantes e puérperas admitidas na unidade de cuidados intensivos.Material e Métodos: Estudo retrospetivo de todas as admissões obstétricas na unidade de cuidados intensivos no período de 2000 a 2017.Resultados: Noventa e três mulheres necessitaram de internamento em Cuidados Intensivos (0,7 por 1000 partos e 0,8% de todas as admissões de adultos). A média de idades foi de 30,3 anos, a idade gestacional média foi 33,6 semanas, 51 (54,8%) eram primíparas, nove (9,7%) eram gravidezes gemelares e cinco (5,4%) não tinham sido vigiadas durante a gravidez. Oitenta e quatro (90,3%) foram admitidas no período pós-parto imediato. Os motivos mais comuns de internamento foram os distúrbios hipertensivos da gravidez (35,5%) e hemorragia obstétrica (24,7%). A mediana do tempo de internamento foi de cinco dias. A transfusão de hemoderivados foi necessária em 53 (57,0%), ventilação artificial em 50 (53,8%) e uso de vasopressores em 21 (22,6%). Observámos quatro óbitos maternos (4,3%). A maioria das doentes (95,7%) recuperaram e foram transferidas para outros serviços. O valor do Sequential Organ Failure Assessment score teve associação estaticamente significativa com a mortalidade materna.Discussão: Os resultados obtidos são comparáveis aos obtidos em outros estudos. A mortalidade materna foi semelhante à mortalidade materna nos países desenvolvidos.Conclusão: A incidência de admissões obstétricas numa unidade de cuidados intensivos foi de 0,8% e 0,7 por 1000 partos. Os distúrbios hipertensivos da gravidez foram as principais causas de internamento. A mortalidade materna foi de 4,3%. Estudos de morbilidade materna são importantes e podem ajudar a melhorar a qualidade dos serviços de saúde.Ordem dos Médicos2019-11-04info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentimage/jpeghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11410oai:ojs.www.actamedicaportuguesa.com:article/11410Acta Médica Portuguesa; Vol. 32 No. 11 (2019): November; 693-696Acta Médica Portuguesa; Vol. 32 N.º 11 (2019): Novembro; 693-6961646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11410https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11410/5791https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11410/10874https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11410/11243https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11410/11326https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11410/11444Direitos de Autor (c) 2019 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessOliveira, SaraFilipe, CatarinaHusson, NatachaVilhena, Isabel RuteAnastácio, MargaridaMiranda, MarisaDevesa, Nuno2022-12-20T11:06:15Zoai:ojs.www.actamedicaportuguesa.com:article/11410Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:20:02.283489Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Obstetric Admissions to the Intensive Care Unit: A 18-Year Review in a Portuguese Tertiary Care Centre
Admissões Obstétricas em Unidade de Cuidados Intensivos: Uma Revisão de 18 Anos num Hospital Terciário Português
title Obstetric Admissions to the Intensive Care Unit: A 18-Year Review in a Portuguese Tertiary Care Centre
spellingShingle Obstetric Admissions to the Intensive Care Unit: A 18-Year Review in a Portuguese Tertiary Care Centre
Oliveira, Sara
Intensive Care Units
Maternal Mortality
Pregnancy
Pregnancy Complications
Complicações na Gravidez
Gravidez
Mortalidade Materna
Unidades de Cuidados Intensivos
title_short Obstetric Admissions to the Intensive Care Unit: A 18-Year Review in a Portuguese Tertiary Care Centre
title_full Obstetric Admissions to the Intensive Care Unit: A 18-Year Review in a Portuguese Tertiary Care Centre
title_fullStr Obstetric Admissions to the Intensive Care Unit: A 18-Year Review in a Portuguese Tertiary Care Centre
title_full_unstemmed Obstetric Admissions to the Intensive Care Unit: A 18-Year Review in a Portuguese Tertiary Care Centre
title_sort Obstetric Admissions to the Intensive Care Unit: A 18-Year Review in a Portuguese Tertiary Care Centre
author Oliveira, Sara
author_facet Oliveira, Sara
Filipe, Catarina
Husson, Natacha
Vilhena, Isabel Rute
Anastácio, Margarida
Miranda, Marisa
Devesa, Nuno
author_role author
author2 Filipe, Catarina
Husson, Natacha
Vilhena, Isabel Rute
Anastácio, Margarida
Miranda, Marisa
Devesa, Nuno
author2_role author
author
author
author
author
author
dc.contributor.author.fl_str_mv Oliveira, Sara
Filipe, Catarina
Husson, Natacha
Vilhena, Isabel Rute
Anastácio, Margarida
Miranda, Marisa
Devesa, Nuno
dc.subject.por.fl_str_mv Intensive Care Units
Maternal Mortality
Pregnancy
Pregnancy Complications
Complicações na Gravidez
Gravidez
Mortalidade Materna
Unidades de Cuidados Intensivos
topic Intensive Care Units
Maternal Mortality
Pregnancy
Pregnancy Complications
Complicações na Gravidez
Gravidez
Mortalidade Materna
Unidades de Cuidados Intensivos
description Introduction: Maternal mortality and morbidity are important indicators of the quality of health-care services. Obstetric admissions to an intensive care unit may be considered a marker of maternal morbidity. The aim of this study was to determine the incidence, maternal morbidity and mortality of pregnant and postpartum women who required admission to the intensive care unit.Material and Methods: Retrospective analysis of all the obstetric patients admitted to the intensive care unit between 2000 and 2017. Results: Ninety-three women required admission to intensive care (0.7 per 1000 deliveries, 0.8% of all adult admissions). Mean age was 30.3 years, mean gestational age was 33.6 weeks, 51 (54.8%) were primiparous, nine (9.7%) were pregnant of twins and five (5.4%) had not been followed during pregnancy. Eighty-four (90.3%) were admitted after immediate delivery. The most common reasons for admission were hypertensive disorders of pregnancy (35.5%) and obstetric haemorrhage (24.7%). Median length of stay was five days. Transfusion of blood products was needed in 23 (57.0%), artificial ventilation in 50 (53.8%) and use of vasopressors in 21 (22.6%). We observed four maternal deaths (4.3%). Most patients (95.7%) successfully recovered and were transferred to other departments. Sequential Organ Failure Assessment score was significantly associated with maternal mortality.Discussion: Our results are comparable to those obtained in other studies. Maternal mortality was comparable to maternal mortality in developed countries.Conclusion: The incidence of obstetric admissions to the intensive care unit was 0.8% and 0.7 per 1000 deliveries. Hypertensive disorders of pregnancy were the main causes of admission. Maternal mortality was 4.3%. Studies of maternal morbidity are important and can help to improve the quality of health care services.
publishDate 2019
dc.date.none.fl_str_mv 2019-11-04
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11410
oai:ojs.www.actamedicaportuguesa.com:article/11410
url https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11410
identifier_str_mv oai:ojs.www.actamedicaportuguesa.com:article/11410
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11410
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11410/5791
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11410/10874
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11410/11243
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11410/11326
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11410/11444
dc.rights.driver.fl_str_mv Direitos de Autor (c) 2019 Acta Médica Portuguesa
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Direitos de Autor (c) 2019 Acta Médica Portuguesa
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/vnd.openxmlformats-officedocument.wordprocessingml.document
application/vnd.openxmlformats-officedocument.wordprocessingml.document
application/vnd.openxmlformats-officedocument.wordprocessingml.document
image/jpeg
dc.publisher.none.fl_str_mv Ordem dos Médicos
publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 32 No. 11 (2019): November; 693-696
Acta Médica Portuguesa; Vol. 32 N.º 11 (2019): Novembro; 693-696
1646-0758
0870-399X
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
repository.mail.fl_str_mv
_version_ 1799130649392578560