Poster Presentation Women's Health Forum 2021

Trends in obstetric referrals to the Intensive Care Unit in a large quaternary obstetric centre in Australia over the past 25 years (#64)

Andras I Nyikovics 1 , John T Morgan 1 , Alison Griffin 1 , Rebecca S King 1 , Jessica Byrnes 1 , Shelly Lee 1 , Esmond Hii 1 , Sally Chan 1 , Jenny May 1 , Gowri Ravichandran 1 , Tyson Jones 1 , Paul Lim 1 , Justin Lim 1 , Omar Yousif 1 , Oindrila Das 1 , Emmanuelle Koehl 1
  1. Mater Misericordiae Ltd, South Brisbane, QLD, Australia

Objective: To evaluate obstetric referrals to the Intensive Care Unit (ICU) and identify demographics, most frequent causes for referral and associated clinical outcomes.

Design: A retrospective cohort study of obstetric referrals to ICU at Mater Misericordiae Ltd. between 2010 – 2019; with comparison of trends over the last 25 years, comparing our dataset to two previous studies from the same institution (1994-1997 and 2007-2009).

Population: All females referred to ICU, either pregnant or within 6 weeks of childbirth

Methods: Three separate databases were searched and cross-referenced: 1.) Mater Campus-wide ICU discharge summary database, 2.) Mater Health patient information database, 3.) Australasian Outcomes Research Tool for Intensive Care Adult Patient Database (AORTIC database). 

Outcome measures: Occurrence, indications, course, interventions and clinical outcomes of obstetric admissions; focusing on characteristics, demographics and temporal trends over the last more than 2 decades.

Results: We identified 1221 individual patients with 1260 patient separations (34 patients admitted more than once). Mean ICU length of stay was 30.2 hours (SD 21.0-44.5); median APACHE III score was 31 (IQR 24-40). Emergency admissions comprised of 88.3% of total. 88.7% of patients were admitted post-partum. One patient died while in ICU (overall ICU mortality 0.08%). 82.1% of patients had an obstetric diagnosis (most frequently hypertensive diseases of pregnancy – 38.7%, and obstetric haemorrhage – 31.9%). The proportion of patients of all ICU admissions, and of total obstetric admissions peaked between 2012-2014, and then steadily decreased. Of those admitted to ICU, the proportion of receiving an ICU intervention steadily decreased from 2011.

Conclusions: Maternal mortality is extremely low at our institution. There is a decrease over the years in the proportion of obstetric patients referred to ICU.

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