Title: A Study of the Spectrum of Critically Ill Obstetric Cases Admitted in Medical ICU in Central India
Authors: Dr Shuhaib M, Dr Neelima Singh, Dr Sylvester Justin Stephen
DOI: https://dx.doi.org/10.18535/jmscr/v7i5.107
Abstract
Background: Maternal mortality is an important public health problem especially in backward states of India like Madhya Pradesh. Obstetric cases may also have serious medical causes of morbidity and mortality which maybe preventable. The knowledge of their spectrum may help in instituting steps for their prevention.
Aims: To study the spectrum of critically ill obstetric cases admitted in Medical ICU in Gwalior.
Methodology: This is a prospective observational study conducted among obstetric patients admitted to Medical ICU between January 2017 to September 2018 in a medical college in Gwalior.
Results: A total of 100 consecutive cases were studied and the mean age of the subjects was 24 years. 62 % of the patients were ANC and 38% were PNC. Majority of the ANC patients were multigravida (58.03%).Most common diagnosis in the present study was Severe Anaemia (31%). Overall mortality was 13% with overwhelming majority having a qSOFA score ≥2(P < 0.001).Most common cause of mortality in present study was Hepatic encephalopathy (53.84%) followed by Severe anaemia with sepsis (30.77%). Most common interventions required were packed RBC transfusions (67%), followed by mechanical ventilation (12%) and inotropic support (12%).
Conclusion: The qSOFA score was found to be an important tool in predicting mortality. Most common diagnosis was Severe Anemia and the most common cause of mortality was Hepatic encephalopathy (due to viral hepatitis). Packed RBC transfusions, mechanical ventilation and inotropic support were the commonest interventions required. Thus the causes of morbidity and mortality in this crucial subset of patients can be tackled by effective public health measures in our study population.
Keywords: Obstetric patients, Medical ICU, qSOFA score.
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