CRITICAL ILLNESS IN PREGNANCY - AN ANALYSIS OF 20 PATIENTS ADMITTED TO A MEDICAL INTENSIVE-CARE UNIT

There is a paucity of literature with regard to the need for intensive care treatment of critically ill obstetric patients. In this review, the findings from 20 obstetric patients admitted to a medical ICU (MIC U) over a 40-month period were analyzed. Demographics, preexistent med ical problems, diagnoses, days in the hospital and the MICU, need for mechanical ventilation, maternal and fetal mortality, and invasive pro cedures were reviewed. (For comparison, a limited analysis of nonobste tric admissions to the MICU over the same time period were included.) Fifty percent (10) of the patients had preexisting medical problems. M aternal mortality was 20 percent (4 patients), with a fetal mortality of 35 percent (7). In all of the maternal deaths, adult respiratory di stress syndrome was present. Although mortality and the need for mecha nical ventilation did not differ between the obstetric and nonobstetri c patients, pulmonary artery and arterial catheters were placed at a h igher rate in the obstetric patients. Critically ill obstetric patient s, although younger than general MICU patients, appear to have as grea t a risk of dying of their critical illness and have a high infant mor tality.