Obstetric admissions to the Intensive Care Unit in Malta (2012-2015) : a nationwide, population-based, cohort study

Abstract

Background: To the authors’ knowledge, obstetric admissions to Malta’s ICU have not been studied. Local information was needed to compare with international data.

Methods: Patients were recruited retrospectively through the ICU admissions database for 2012 - 2015. Those admitted for obstetric pathology at any stage of pregnancy and up to 30 days postpartum were included in the study. Medical notes were reviewed. Data collected included demographics; obstetric history; admission diagnosis; management including surgery; length of ICU and hospital stay; and maternal and neonatal outcomes. Data was analysed using MS Excel®.

Results: 42 obstetric patients were admitted to ICU over the four year period; 39 were included in the study. 0.25% of obstetric deliveries needed admission to ICU and obstetric admissions accounted for 0.87% of all ICU admissions. The commonest admission diagnosis was haemorrhage (62%), followed by hypertensive disorders of pregnancy (26%). All patients had an arterial line inserted and for 33%, this was the only intensive care intervention. 26 patients (67%) required surgery – most commonly, an emergency Lower Segment Caesarian Section (LSCS). There were no maternal deaths over this period. However, four patients miscarried their pregnancy and there were three perinatal deaths.

Conclusion: The percentage of deliveries requiring ICU admission in Malta is in line with rates reported in the literature. However, obstetric patients in Malta make up a smaller percentage of all ICU admissions than published rates. The most common admission diagnosis was haemorrhage, in contrast with most studies, where admission was commonly due to hypertensive disorders of pregnancy.