Published: 2022-10-28

Study on clinical profile, scoring systems and outcomes of obstetric patients in our intensive care unit

Swapna Mandala Babu, Deepak Ivan Tauro, Indira Menon, Deepa Das, Shivkumar Shivanna, Philip Karkare


Background: Obstetric patients in ICU, pose a clinical challenge to intensivists and obstetricians. The objective of our study was to evaluate the incidence, indications and interventions in these patients. Secondly to assess whether clinical scores can help to estimate severity of the condition, predict mortality and morbidity in these patients.

Methods: It was a retrospective observational study including all antepartum and postpartum patients admitted to ICU between January 2018 to June 2020.

Results: Majority of patients needing ICU care were in the antepartum period (82.8%). Multigravida (55.2%) and unbooked cases (60.4%) constituted a major proportion of patients. Hypertensive disorders of pregnancy followed by sepsis amounted for common etiologies. Transfusions (43.2%), ventilatory support (26%) followed by inotropic support (14.9%) were the interventions required in the majority number of patients. Maternal mortality rate was 2.23%. Out of the clinical scores, OEWS (Obstetric early warning score) was a better modality to assess the severity of the disease and the need for ICU care.

Conclusions: A multidisciplinary approach and close coordinated care of obstetric patients can reduce the maternal mortality rate. Early identification of critically ill obstetric patients using clinical scores can help us in triaging patients to high dependency units/ICU. OEWS is a very simple score which helps us in identifying patients needing intensive care.


ICU care, Obstetric patients, OEWS, Interventions, Severity scores

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Atrash HK, Alexander S, Berg CJ. Maternal mortality in developed countries: not just a concern of the past. Obstet Gynecol. 1995;86(4Pt2):700-5.

World Health Organization. Trends in maternal mortality 2000 to 2017: estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. World Health Organization; 2019.

Pollock W, Rose L, Dennis CL. Pregnant and postpartum admissions to the intensive care unit: a systematic review. Intens Care Med. 2010;36(9):1465-74.

Hazelgrove J, Price C, Pappachan V, Smith G. Multicenter study of obstetric admissions to 14 intensive care units in southern England. Crit Care Med. 2001;29(4):770-5.

Witteveen T, de Koning I, Bezstarosti H, van den Akker T, van Roosmalen J, Bloemenkamp KW. Validating the WHO Maternal Near Miss Tool in a high-income country. Acta Obstet Gynecol Scand. 2016;95(1):106-11.

Gupta S, Naithani U, Doshi V, Bhargava V, Vijay BS. Obstetric critical care: A prospective analysis of clinical characteristics, predictability, and fetomaternal outcome in a new dedicated obstetric intensive care unit. Indian J Anaesth. 2011;55(2):146-53.

Bahadur BR, Kodey P, Tanniru J, Tirumala S. Study of outcome of obstetric emergencies admitted to intensive care unit. Int J Reprod Contracept Obstet Gynecol. 2018; 7:2909-14.

Gupta H, Gandotra N, Mahajan R. Profile of Obstetric Patients in Intensive Care Unit: A Retrospective Study from a Tertiary Care Center in North India. Indian J Crit Care Med. 2021;25(4):388-91.

Verma D, Rathore AM. Obstetric admissions to the intensive care unit of a tertiary hospital in northern India. Int Jour of Biomed Res. 2014;5(9):539-42.

Joseph CM, Bhatia G, Abraham V, Dhar T. Obstetric admissions to tertiary level intensive care unit- prevalence, clinical characteristics and outcomes. Indian J Anaesth. 2018;62:940-4.

Bhadade R, De’Souza R, More A, Harde M. Maternal outcomes in critically ill obstetrics patients: a unique challenge. Indian J Crit Care Med. 2012;16(1):8-16.

Ashraf N, Mishra SK, Kundra P, Veena P, Soundaraghavan S, Habeebullah S. Obstetric patients requiring intensive care: a one year retrospective study in a tertiary care institute in India. Anesthesiol Res Pract. 2014;2014:789450.

Chawla S, Nakra M, Mohan S, Nambiar BC, Agarwal R, Marwaha A. Why do obstetric patients go to the ICU? A 3-year-study. Med J Armed Forces India. 2013;69(2):134-7.

Saha R, Shakya A. Study of obstetric patients admitted to intensive care unit at Kathmandu Medical College Teaching Hospital. J Kathmandu Med Coll. 2013;2(4):196-200.

Paternina-Caicedo AJ, Rojas-Suarez JA, Dueñas-Castel C, Mir-anda-Quintero JE, Bourjeily G. Mortality risk prediction with an updated acute physiology and chronic health evaluation II score in critically ill obstetric patients: a cohort study. J Intens Care Med. 2015;30(02):97-102.

Khergade M, Suri J, Bharti R, Pandey D, Bachani S, Mittal P. Obstetric early warning score for prognostication of critically Ill obstetric patients. Indian J Crit Care Med. 2020;24(6):398-403.