Critically ill obstetric and gynaecological patients in the intensive careunit

Objectives. To document mortality among critically ill obstetric and gynaec ological patients requiring intensive care unit (ICU) admission and to inve stigate whether any poor prognostic features could allow for earlier and mo re aggressive intervention. Study design. A retrospective study of all obstetric and gynaecological pat ients admitted to the ICU of Johannesburg Hospital between 1985 and 1996. S ixty-one patients were analysed both as a group and as two subgroups-those with incomplete abortions and those with other pregnancy-related diagnoses. Results. Derangements in platelet counts, serum creatinine levels and proth rombin international normalised ratio (INR) were present in all patients on the day of admission to hospital. In the group with incomplete abortions a bsolute levels of these parameters may be used to identify those patients w ith a worse outcome. The mortality rate was 38% Conclusion. Early ICU admission and aggressive surgical intervention are st rongly recommended in patients with septic incomplete abortions presenting with more than a single organ dysfunction.