ETIO-PATHOPHYSIOLOGICAL PROFILE AND OUTCOME OF CRITICALLY ILL OBSTETRIC PATIENTS ADMITTED TO OBSTETRIC INTENSIVE CARE UNIT AT A TERTIARY CARE OBSTETRIC HOSPITAL IN KASHMIR VALLEY: A RETROSPECTIVE COHORT ANALYSIS.

Objective: To evaluate the reasons for admission and outcomes of obstetric patients admitted to the Intensive Care Unit at the tertiary care obstetric hospital of GMC Srinagar over a period of one year. Study design: Retrospective cohort analysis. Setting and Methods: Data of obstetric patients admitted to the Obstetric ICU of Lalla Ded hospital, a tertiary care obstetric hospital of GMC Srinagar, between January 2016 and January 2017 was retrospectively reviewed. Patient demographics, reason for ICU admission, need for ventilatory support and outcome were assessed. Results: Over the study period, 33,594 patients were admitted to the hospital, of which 31985 were obstetric and 1609 were gynaecology cases. 303 obstetrical patients out of 31985 patients (0.9%) needed ICU admission. Out of these ICU admissions, 131 patients (43%) were referred from other health centers, 101 (33%) required ventilator support. Nearly half (43.56%) were admitted due to severe obstetric hemorrhage, while 37.95% had pregnancy related hypertension with its complications followed by pregnancy with underlying cardiac disease including Peripartum cardiomyopathy and rheumatic heart diseases and sepsis. Overall mortality within the unit was 19 (6.27%) during the study period. Conclusion: Obstetric haemorrhage and complications of pregnancy related hypertension are the leading causes of ICU admission. Early detection with referral to tertiary care centre and involvement of multidisciplinary team with dedicated obstetric intensive care unit is the key to decrease morbidity and improve materno-fetal outcome in high risk pregnancies and in critically ill obstetric patient population.