Women of childbearing age: causes of hospitalization in intensive care unit and results
Main Article Content
Abstract
Introduction: Obstetric patients represent a significant fraction of admissions to intensive care units and consist of a challenge to the team. Objective: To analyze the main causes of maternal death and hospitalization of women of childbearing age occurring in intensive care units of hospitals in a city in Northwestern Paraná, Southern Brazil. Methods: Exploratory, descriptive and retrospective study, conducted with women of childbearing age (10–49 years) admitted in three intensive care units existing in a city of Northwest Paraná, for obstetric and non-obstetric causes, from January 2005 to December 2009. Results: There were 775 admissions of women of childbearing age, with a mean age of 33.7±10.3 years; the mean duration of hospitalization was 5.0±8.4 days. Most of the women were from the municipality (67.2%), with low education level (primary level, 68.2%). Among the obstetric causes of hospitalization, pre-eclampsia and eclampsia constituted the main cause (71.3%); pyelonephritis stood out other conditions during pregnancy (53%). There was no statistical association between hospital admissions for obstetric causes in intensive care unit and death. Conclusion: Non-obstetric causes accounted for the majority of hospitalizations of women of childbearing age in the intensive care unit of this municipality during the study period; among obstetric causes, pre-eclampsia and eclampsia were the main causes.
Downloads
Article Details
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License (CC BY) that allows others to share and adapt the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.References
Price LC, Germain S, Wyncoll D, Nelson-Piercy C. Management of the critically ill obstetric patient. Obstet Gynaecol Reprod Med. 2009;19(12):350-8. http://dx.doi.org/10.1016/j.ogrm.2009.09.004
Amorim MMR, Katz L, Ávila MB, Araújo DE, Valença M, Albuquerque CJM, et al. Perfil das admissões em uma unidade de terapia intensiva obstétrica de uma maternidade brasileira. Rev Bras Saúde Mater Infant. 2006;6(Suppl 1):s55-62. ttp://dx.doi.org/10.1590/S1519-38292006000500008.
World Health Organization (WHO) [Internet]. World Health Statistics 2009. Disponível em: http://www.who.int/whosis/whostat/ EN_WHS09_Full.pdf. Acesso em: 10 jan. 2010.
Mahutte NG, Murphy-Kaulbeck L, Le Q, Solomon J, Benjamin A, Boyd A. Obstetric admissions to the intensive care unit. Obstet Gynecol. 1999;94(2):263-6. http://dx.doi.org/10.1016/S0029-7844(99)00274-4
Amaral E, Luz AG, Souza JPD. A morbidade materna grave na qualificação da assistência: utopia ou necessidade? Rev Bras Ginecol Obstetr. 2007;29(9):484-89. http://dx.doi.org/10.1590/S0100-72032007000900008
Pollock W, Rose L, Dennis CL. Pregnant and postpartum admissions to the intensive care unit: a systematic review. Intensive Care Med. 2010;36(9):1465-74. http://dx.doi.org/10.1007/s00134-010-1951-0
Thonneau PF, Matsudai T, Alihonou E, Souza J, Faye O, Moreau JC, et al. Distribution of causes of maternal mortality during delivery and post-partum: results of an African multicentre hospital-based study. Eur J Obstet Gynecol Reprod Biol. 2004;114(2):150-4. http://dx.doi.org/10.1016/j.ejogrb.2003.12.004
Vasquez DN, Estenssoro E, Canales HS, Reina R, Saenz MG, Neves AV, et al. Clinical characteristics and outcomes of obstetric patients requiring ICU admission. Chest. 2007;131(3):718-24. http://dx.doi.org/10.1378/chest.06-2388
Souza JP, Cecatti JG, Parpinelli MA, Sousa MH, Serruya SJ. Revisão sistemática sobre morbidade materna near miss. Cad Saúde Pública. 2006;22(2):255-64. http://dx.doi.org/10.1590/S0102-311X2006000200003
Souza JP, Cecatti JG. The near-miss maternal morbidity scoring system was tested in a clinical setting in Brazil. J Clin Epidemiol. 2005;58(9):962. http://dx.doi.org/10.1016/j.jclinepi.2005.02.011
Amaral E, Souza JP, Surita F, Luz AG, Sousa MH, Cecatti JG, et al. A population-based surveillance study on severe acute maternal morbidity (near-miss) and adverse perinatal outcomes in Campinas, Brazil: the Vigimoma Project. BMC Pregnancy Childbirth. 2011;11:9. http://dx.doi.org/10.1186/1471-2393-11-9
Amorim MMR, Katz L, Santos LC. Terapia intensiva em obstetrícia. Femina. 2007;35(2):107-11.
Anwari JS, Butt AA, Al-Dar MA. Obstetric admissions to the intensive care unit. Saudi Med J. 2004;25(10):1394-9.
Geller SE, Adams MG, Kominiarek MA, Hibbard JU, Endres LK, Cox SM, et al. Reliability of a preventability model in maternal death and morbidity. Am J Obstet Gynecol. 2007;196(1):57. e1-6.
Laurenti R, Jorge MHPM, Gotlieb SLD. A mortalidade materna nas capitais brasileiras: algumas características e estimativa de um fator de ajuste. Rev Bras Epidemiol. 2004;7(4):449-60. http://dx.doi.org/10.1590/S1415-790X2004000400008
Cecconelo F, Ferraz L. O perfil sócio-demográfico e patológico de gestantes e puérperas admitidas na UTI de um hospital do Oeste Catarinense. Rev Divulg Cient. 2010;17(1):71-8.
Cheng C, Raman S. Intensive care use by critically ill obstetric patients: a five-year review. Int J Obstet Anesth. 2003;12(2):89-92.
Gilbert TT, Smulian JC, Martin AA, Ananth CV, Scorza W, Scardella AT. Obstetric admissions to the intensive care unit: outcomes and severity of illness. Obstet Gynecol. 2003;102(5 Pt 1):897-903. http://dx.doi.org/10.1016/S0029-7844(03)00767-1
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(6):1294-9. http://dx.doi.org/10.1097/01.CCM.0000128549.72276.00
Zeeman GG. Obstetric critical care: a blueprint for improved outcomes. Crit Care Med. 2006;34(9 Suppl):S208-14.
Amorim MMR, Katz L, Valença M, Araújo DE. Morbidade materna grave em UTI obstétrica no Recife, região nordeste do Brasil. Rev Assoc Med Bras. 2008;54(3):261-6. http://dx.doi.org/10.1590/S0104-42302008000300021
Luz AG, Tiago DB, Silva JC, Amaral E. Severe maternal morbidity at a local reference university hospital in Campinas, São Paulo, Brazil. Rev Bras Ginecol Obstet. 2008;30(6):281-6. http://dx.doi.org/10.1590/S0100-72032008000600003
Souza JP, Cecatti JG, Parpinelli MA, Serruya SJ, Amaral E. Appropriate criteria for identification of near-miss maternal morbidity in tertiary care facilities: a cross sectional study. BMC Pregnancy Childbirth. 2007;11(7):20.http://dx.doi.org/10.1186/1471-2393-7-20
Morse ML, Fonseca SC, Gottgtroy CL, Waldmann CS, Gueller E. Morbidade materna grave e Near Misses em Hospital de Referência Regional. Rev Bras Epidemiol. 2011;14(2):310-22. http://dx.doi.org/10.1590/S1415-790X2011000200012
Orsini J, Butala A, Diaz L, Muzylo E, Mainardi C, Kastell P. Clinical profile of obstetric patients admitted to the Medical-Surgical Intensive Care Unit (MSICU) of an Inner-City Hospital in New York. J Clin Med Res. 2012;4(5):314-7.
Zwart JJ, Dupuis JR, Richterns A, Ory F, van Roosmalen J. Obstetric intensive care unit admission: a 2-year nationwide population-based cohort study. Intensive Care Med. 2010; 36(2):256-63. http://dx.doi.org/10.1007/s00134-009-1707-x
Lotufo FA, Parpinelli MA, Haddad SM, Surita FG, Cecatti JG. Applying the new concept of maternal near-miss in an intensive care unit. Clinics. 2012;67(3):225-30. http://dx.doi.org/10.6061/clinics/2012(03)04
Sousa MH, Cecatti JG, Hardy EE, Serruya SJ. Severe maternal morbidity (near miss) as a sentinel event of maternal death. An attempt to use routine data for surveillance. Reprod Health. 2008;5:6. http://dx.doi.org/10.1186/1742-4755-5-6
Adisasmita A, Deviany PE, Nandiaty F, Stanton C, Ronsmans C. Obstetric near miss and deaths in public and private hospitals in Indonesia. BMC Pregnancy Childbirth. 2008;8:10. http://dx.doi.org/10.1186/1471-2393-8-10
Coelho MAL, Katz L, Coutinho I, Hofmann A, Miranda L, Amorim M. Perfil de mulheres admitidas em uma UTI obstétrica por causas não obstétricas. Rev Assoc Med Bras. 2012;58(2):160-7. http://dx.doi.org/10.1590/S0104-42302012000200011