A Study on Obstetric Cases Requiring Critical Care Unit (CCU) Admission at Burdwan Medical College and Hospital

Abstract

Introduction : Obstetric emergencies are a challenge to the obstetrician because of the unique nature of obstetric medicine. The altered physiology of pregnancy, the presence of the fetus, the rapid deterioration of maternal and fetal condition in case of a complication, and the simultaneous management of two lives with different physiologies are a challenge. Objectives :  Keeping this in mind, present study was planned to analyze obstetric admissions in critical care unit and to study the management and outcome of such cases. Methods : The present hospital based prospective observational study was conducted in the Critical Care Unit and in the Department of Gynaecology and Obstetrics of Burdwan Medical College & Hospital between January 2017 to June 2018. Total 264 Obstetric cases admitted to CCU were included in the study. Statistical data were analysed by using Microsoft Excel and SPSS V.20 software. Results : In the present study mean age of the patients admitted to the CCU was 23.6+5.36 years. Among the total admissions 66 cases (25 %) had no antenatal visits. Total 77% of patients admitted at term, whereas preterm admission was 14.4%. Mean gestational age is 35.04±8.17 weeks. Majority of the patients were delivered by caesarean section (72.7%). The direct obstetric causes accounted for 87.1% of the total admissions in CCU and medical causes complicating pregnancy were 12.9%. Of the 264 patients admitted to CCU, Hypertensive disorder of pregnancy was the major obstetric cause (50%) followed by Obstetric haemorrhage (28.8%) and sepsis (8.3%). The reasons of CCU admission were low GCS (43.5%), followed by respiratory distress (31.4%), hypotension (17%) and refractory seizures (4.9%). Among the total patients admitted in CCU, 74.6% survived and 25.4% expired. Conclusions : Awareness should be created among the population regarding the importance of adequate antenatal care; detection of the danger signs of various obstetric complications and need for contacting the medical facility at the earliest in a case of emergency situations.