GÖNÜL TEZCAN KELEŞ, İSMET TOPÇU, Arzu KEFİ, Zeynep EKİCİ, Melek SAKARYA

Yoğun bakım ünitesinde obstetrik olgular

Amaç: Bu çalışmanın amacı Yoğun bakım ünitesine (YBÜ)'ne alınan obstetrik olguları retrospektif olarak değerlendirmek, YBÜ'ne kabul sıklığını, nedenlerini ve klinik sonuçlarını araştırmaktır. Gereç ve Yöntem: Yoğun bakım ünitesine (YBÜ) 1999-2005 yılları arasında gebe ve/veya postpartum dönemde yatırılan 18 obstetrik olgunun retrospektif demografik verileri, kabul nedenleri, yoğun bakımda yapılan girişimleri ve klinik sonuçları incelenerek değerlendirilmeye alındı. Bulgular: Obstetrik olguların YBÜ'ndeki sıklığı %2.7 olarak bulundu. 13 olgu (%72.2) diğer hastanelerden sevk edilmiştir. Yoğun bakım kullanma oranımız 421 doğumda 1'dir. 18 olgunun ortalama yaşı 27.4±5.4'tür. Yatış süreleri 4.6 gün ve APACHE II skoru orta değeri 7'dir. Yaşayan ile yaşamayan olgular arasında APACHE II skorları farklı bulundu (p

Anahtar Kelimeler:

Hipertansiyon, gebeliğe bağlı, Eklampsi, Doğum sonrası kanama, Yoğun bakım üniteleri, Preeklampsi, Gebelik komplikasyonları, Geriyedönük çalışma, Şok, APACHE

Obstetric patients in intensive care unit

Objectives: We analyzed retrospectively all obstetric admission to determine the causes and outcomes of intensive care unit. Materials and Methods: In this study; 18 obstetric patient referred to ICU from 1999 to 2005 in pregnancy and/or postpartum period, were evaluated by observing demographic data, admittance reasons, interventions in ICU and clinical outcomes. Results: Incidence of obstetric cases in ICU was obtained as 2.7%. 13 cases (72.2%) were delivered from other hospitals. ICU requirement rate is 1 per 421 deliveries. Mean age of 18 patients is 27.4±5.4 years. ICU stay is 4.6 days and median APACHE II score is 7. There were differences APACHE II score between survivors and non-survivors (p<0.05). Most common reasons of ICU admittance were hypertension related to eclampsia/preeclampsia (%38.7) and hypovolemic shock related to postpartum hemorrhage (%27.8). 5 of patients died and mortality rate was found as 27.7%. Conclusion: ICU requirement for obstetric cases was seen mostly because of obstetric hemorrhage and uncontrolled hypertension. Strategies improved for solving these problems and regular antenatal care would significantly decrease major maternal morbidity and mortality.

Keywords:

Hypertension, Pregnancy-Induced, Eclampsia, Postpartum Hemorrhage, Intensive Care Units, Pre-Eclampsia, Pregnancy Complications, Retrospective Studies, Shock, APACHE,

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