Obstetric Patients in Intensive Care Unit

Yıl 2006, Cilt: 11 Sayı: 1, 62 - 65, 01.02.2006

Gönül Tezcan Keleş İsmet Topçu Arzu Kefi Zeynep Ekici Melek Sakarya

Öz

Objectives: We analyzed retrospectively all obstetric admission to determine the causes and outcomes of intensive care unit. Materials and Methods: In this study; 18 obstetric patient referred to ICU from 1999 to 2005 in pregnancy and/or postpartum period, were evaluated by observing demographic data, admittance reasons, interventions in ICU and clinical outcomes. Results: Incidence of obstetric cases in ICU was obtained as 2.7%. 13 cases (72.2%) were delivered from other hospitals. ICU requirement rate is 1 per 421 deliveries. Mean age of 18 patients is 27.4±5.4 years. ICU stay is 4.6 days and median APACHE II score is 7. There were differences APACHE II score between survivors and non-survivors (p

Anahtar Kelimeler

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Yoğun Bakım Ünitesinde Obstetrik Olgular

Öz

Amaç: Bu çalışmanın amacı Yoğun bakım ünitesine (YBÜ)'ne alınan obstetrik olguları retrospektif olarak değerlendirmek, YBÜ'ne kabul sıklığını, nedenlerini ve klinik sonuçlarını araştırmaktır. Gereç ve Yöntem: Yoğun bakım ünitesine (YBÜ) 1999-2005 yılları arasında gebe ve/veya postpartum dönemde yatırılan 18 obstetrik olgunun retrospektif demografik verileri, kabul nedenleri, yoğun bakımda yapılan girişimleri ve klinik sonuçları incelenerek değerlendirilmeye alındı. Bulgular: Obstetrik olguların YBÜ'ndeki sıklığı %2.7 olarak bulundu. 13 olgu (%72.2) diğer hastanelerden sevk edilmiştir. Yoğun bakım kullanma oranımız 421 doğumda 1'dir. 18 olgunun ortalama yaşı 27.4±5.4'tür. Yatış süreleri 4.6 gün ve APACHE II skoru orta değeri 7'dir. Yaşayan ile yaşamayan olgular arasında APACHE II skorları farklı bulundu (p

Anahtar Kelimeler

Gebelik, preeklampsi, eklampsi, postpartum hemoraji, yoğun bakım ünitesi

Kaynakça

• Berg CJ, Atrash HK, Koonin LM, Tucker M. Pregnancy-related mortality in United States, 1987-1990. Obstet Gynecol 1996; 88:161-7.
• Panchal S, Arria AM, Haris AP. Intensive care utilization during hospital admission for delivery. Prevalence, risk factors, and outcomes in a statewide population. Anesthesiology 2000; 92:1537-44.
• Baskett TF, Sternadel J. Maternal intensive care and near-miss mortality in obstetrics. Br J Obstet Gynaecol 1998; 105:981-4.
• Tripathi R, Rathore AM, Saran S. Intensive care for critically ill obstetric patients. Int J Gynaecol Obstet 2000; 68: 257-8.
• Mahutte NG, Murphy-Kaulbeck L, Le Q, Solomon J, Benjamin A, Boyd ME. Obstetric admissions to the intensive care unit. Obstet Gynecol 1999; 94: 263-6.
• Atrash HK, Koonin LM, Lawson HW, Franks AL, Smith JC. Maternal mortality in the United States, 1976-1986. Obstet Gynecol 1990; 76: 1055-60.
• T.C. Sağlık Bakanlığı. (2005) Ana Çocuk Sağlığı ve Aile Planlaması Genel Müdürlüğü. Ana ve Çocuk Ölümlerini Önleme Projesi. Web sayfası: http://www.saglik.gov.tr
• Yanık FF, Malatyalıoğlu E, Koçak İ, Yanık A, Bolat İ, Kökçü A. Analysis of the pregnancy-related deaths within the last two decades: a university hospital-based study from Turkey. Eur J Obstet Gynecol Reprod Biol 1999; 87: 143-5.
• Demirkiran O, Dikmen Y, Utku T, Urkmez S. Critically ill obstetric patients in the intensive care unit. International Journal of Obstetric Anesthesia 2003; 12: 266-70
• Graham SG, Luxton MC. The requirement for intensive care support for pregnant population. Anaesthesia 1989; 44: 581-4.
• Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: A severity of disease classification system. Crit Care Med 1985; 13: 818-29.
• Karnad DR, Lapsia V, Krishnan A, Salvi VS. Prognostic factors in obstetric patients admitted to an Indian intensive care unit. Crit Care Med 2004; 32: 1294-9.
• El-Solh AA, Grant BJ. A comparison of severity of illness scoring systems for critically ill obstetric patients. Chest 1996; 110: 1299-304.
• Lapinsky SE, Kruczynski K, Seaward GR, Farine D, Grossman RF. Critical care management of the obstetric patient. Can J Anaesth 1997; 44: 325-9.
• Bhagwanjee s, Paruk F, Moodley J, Muckart DJ. Intensive care unit morbidity and mortality from eclampsia:an evaluation of the Acute Physiology and Chronic Health Evaluation II score and the Glasgow Coma Scale score. Crit Care Med 2000; 28: 120-4.
• Cohen J, Singer P, Kogan A, Hod M, Bar J. Course and outcome of obstetric patients in a general intensive care unit. Acta Obstet Gynecol Scand 2000; 79: 846-50.
• Waterstone M, Bewley S, Wolfe C. Incidence and predictors of severe obstetric morbidity: case-control study. BMJ 2001; 322: 1089-94.
• Collop NA, Sahn SA. Critical illness in pregnancy. An analysis of 20 patients admitted to a medical intensive care unit. Chest 1993; 103: 1548-52.
• Nolan TE, Wakefield M, Devoe LD. Invasive hemodynamic monitoring in obstetrics. A critical review of its indications, benefits, complications, and alternatives. Chest 1992; 101: 1429- 33.
• Mabie WC, Barton JR, Sibai BM. Adult respiratory distress syndrome in pregnancy. Am J Obstet Gynecol 1992; 167: 950-7.
• Mabie WC, Sibai BM. Treatment in an obstetric intensive care unit. Am J Obstet Gynecol 1990; 162: 1-4.
• Kabul Tarihi: 05.01.2006