Obstetric admissions to the intensive care unit in Malta over a six year period (2016-2021)

Abstract

BACKGROUND: This is a retrospective evaluation of obstetric admissions to Mater Dei Hospital’s (MDH) ICU between 2016 and 2021. MDH accounts for over 90% of Malta’s deliveries. Comparison to data from a similar study covering 2012-2015 gives information over a 10-year period.

METHODS: Patients were recruited using ICU admissions records. Obstetric patients in any trimester, and up to 30 days postpartum, were included. Data was collected from patient medical records, there was no patient contact. Collected data included demographics, diagnosis, parameters, duration of ICU stay, interventions, and hospital stay. Surgical interventions, maternal and foetal outcomes were noted. MSExcel was used for data analysis.

RESULTS: 55 obstetric patients were admitted to ICU over the six year period; 51 were included in the study. 0.19% of obstetric deliveries needed ICU admission and obstetric admissions accounted for 0.68% of all ICU admissions. The commonest admission diagnosis was haemorrhage followed by hypertensive disorders of pregnancy and sepsis. In patients admitted with haemorrhage, mean blood loss was 2.16L. The mean systolic blood pressure in pre-eclamptic patients was 179mmHg. All patients had an arterial line inserted. 54.9% required overnight stay. 45 patients required surgical intervention, the commonest being an emergency Caesarean section. No maternal deaths were reported. In one case, CPR was performed.

CONCLUSIONS: Malta's rate of obstetric ICU admissions falls within the lower range when compared to international reports. The most common obstetric ICU admission diagnosis is still haemorrhage, in contrast to other international studies where hypertensive disorders of pregnancy prevail.