{
    "abstract": "Obstetric patients presenting to the intensive care units (ICU) with or without underlying medical or surgical comorbidities can be a challenge to both the treating obstetrician and the intensivist. They occasionally present with near-miss events which if left untreated, can result in death.\nTo study the prevalence, indications of ICU admissions, near-miss events, and their effect on mortality in obstetric and puerperal patients\nWe conducted a retrospective analysis of the health records of all the obstetric and puerperal patients (pregnant and until 6\u00a0weeks postpartum) admitted to our tertiary care hospital from January 2019 to December 2020. Patient demographic characteristics, obstetric, surgical, and medical conditions, acute physiology, and chronic health evaluation (APACHE) II scores, organ failures, treatment, ICU and hospital length of stay, and mortality outcomes were studied.\nA total of 22 obstetric patients were admitted to the ICU during the above study period. Mean age was 28.7\u2009\u00b1\u20096.24\u00a0years, mean gestation was 34.4\u2009\u00b1\u20096.61\u00a0weeks, mean APACHE II score was 12.68\u2009\u00b1\u20095.67, median ICU length of stay was 5\u00a0days, and median duration of hospital length of stay was 10\u00a0days. The antepartum risk factors such as severe preeclampsia (27%), antepartum bleeding (14%), and postpartum complications like postpartum haemorrhage (33%), sepsis with multiorgan failure (25%) are the commonest indications that resulted in ICU admission.\nHigher APACHE II scores at the time of ICU admission, prolonged ICU, and hospital length of stay may be associated with high maternal mortality.",
    "authors": [
        {
            "affiliation": "Assistant Professor Department of Anaesthesiology & Critical Care, Command Hospital (EC) , Kolkata, 700027 India.",
            "firstname": "M",
            "initials": "M",
            "lastname": "Krishna Kumar"
        },
        {
            "affiliation": "Assistant Professor Department of Anaesthesiology & Critical Care, Command Hospital (EC) , Kolkata, 700027 India.",
            "firstname": "Aditya",
            "initials": "A",
            "lastname": "Joshi"
        },
        {
            "affiliation": "Assistant Professor Dept of Obstetrics and Gynaecology, Command Hospital (EC) , Kolkata, 700027 India.",
            "firstname": "Monica",
            "initials": "M",
            "lastname": "Saraswat"
        },
        {
            "affiliation": "Professor Dept. of Obstetrics and Gynaecology, ARMED FORCES MEDICAL COLLEGE, Pune, Maharashtra 411040 India.",
            "firstname": "Tony",
            "initials": "T",
            "lastname": "Jose"
        },
        {
            "affiliation": "Professor Dept. of Internal Medicine, Command Hospital (EC) , Kolkata, 700027 India.",
            "firstname": "Rajan",
            "initials": "R",
            "lastname": "Kapoor"
        },
        {
            "affiliation": "Assistant Professor Dept of Obstetrics and Gynaecology, Command Hospital (EC) , Kolkata, 700027 India.",
            "firstname": "Madhulima",
            "initials": "M",
            "lastname": "Saha"
        },
        {
            "affiliation": "Professor Dept of Obstetrics and Gynaecology Command Hospital (SC) , Pune, 411040 India.",
            "firstname": "Bhupesh Kumar",
            "initials": "BK",
            "lastname": "Goyal"
        }
    ],
    "conclusions": "Higher APACHE II scores at the time of ICU admission, prolonged ICU, and hospital length of stay may be associated with high maternal mortality.",
    "copyrights": "\u00a9 Federation of Obstetric & Gynecological Societies of India 2021.",
    "doi": "10.1007/s13224-021-01559-x\n10.4103/joacc.JOACC_57_17\n10.1097/CCM.0000000000002018\n10.1007/s13224-012-0169-1\n10.1016/S2214-109X(14)70227-X\n10.1016/S0140-6736(17)30638-4\n10.1136/bmjopen-2016-012323\n10.4103/0970-0218.137145\n10.4103/0970-258X.295967\n10.1536/ihj.18-729",
    "journal": "Journal of obstetrics and gynaecology of India",
    "keywords": [
        "APACHE II score",
        "Maternal mortality",
        "Near-miss events"
    ],
    "methods": null,
    "publication_date": "2021-09-14",
    "pubmed_id": "34511782\n32470099\n27618276\n24975646\n24564721\n23543189\n25103301\n28456509\n27981719\n27554107\n29675566\n25136152\n32985440\n31019181\n30422862\n27720089\n24004907\n27751799",
    "results": "A total of 22 obstetric patients were admitted to the ICU during the above study period. Mean age was 28.7\u2009\u00b1\u20096.24\u00a0years, mean gestation was 34.4\u2009\u00b1\u20096.61\u00a0weeks, mean APACHE II score was 12.68\u2009\u00b1\u20095.67, median ICU length of stay was 5\u00a0days, and median duration of hospital length of stay was 10\u00a0days. The antepartum risk factors such as severe preeclampsia (27%), antepartum bleeding (14%), and postpartum complications like postpartum haemorrhage (33%), sepsis with multiorgan failure (25%) are the commonest indications that resulted in ICU admission.",
    "title": "Near-Miss Incidents in Obstetric Patients Admitted to an Intensive Care Unit of a Tertiary Care Center in Eastern India: A Retrospective Cohort Study.",
    "xml": "<Element 'PubmedArticle' at 0x78850216e750>"
}