Obstetric admissions to the intensive care unit

Objective: To determine whether obstetric admissions to the intensive care unit (ICU) are useful quality-assurance indicators. Methods: We analyzed retrospectively obstetric ICU admissions at two tertiary care centers from 1991 to 1997. Results: The 131 obstetric admissions represented 0.3% of all deliveries. The majority (78%) of women were admitted to the ICU postpartum. Obstetric hemorrhage (26%) and hypertension (21%) were the two most common reasons for admission. Together with cardiac disease, respiratory disorders, and infection, they accounted for more than 80% of all admissions. Preexisting medical conditions were present in 38% of all admissions. The median Acute Physiology and Chronic Health Evaluation II score was 8.5. The predicted mortality rate for the group was 10.0%, and the actual mortality rate was 2.3%. Conclusion: The most common precipitants of ICU admission were obstetric hemorrhage and uncontrolled hypertension. Improved management strategies for these problems may significantly reduce major maternal morbidity. (C) 1999 by The American College of obstetricians and Gynecologists.