Severe Maternal Morbidity Cases in Israel in a High-Volume High-Resource Referral Center: A Retrospective Cohort Study.


Journal

The Israel Medical Association journal : IMAJ
ISSN: 1565-1088
Titre abrégé: Isr Med Assoc J
Pays: Israel
ID NLM: 100930740

Informations de publication

Date de publication:
Mar 2020
Historique:
entrez: 10 3 2020
pubmed: 10 3 2020
medline: 18 3 2020
Statut: ppublish

Résumé

Admission to an intensive care unit (ICU) is an objective marker of severe maternal morbidity (SMM). To determine the prevalence of obstetric ICU admissions in one medical center in Israel and to characterize this population. In this retrospective study the files of women coded for pregnancy, birth, or the perinatal period and admission to the ICU were pulled for data extraction (2005-2013). During the study period, 111 women were admitted to the ICU among 120,279 women who delivered babies (0.09%). Their average age was 30 ± 6 years, most were multigravida, a few had undergone fertility treatments, and only 27% had complicated previous pregnancies. Most pregnancies (71.2%) were uneventful prior to admission. ICU admissions were divided equally between direct (usually hemorrhage) and indirect (usually cardiac disease) obstetric causes. The indications for obstetrics ICU admission correlated with the proximate causes of maternal arrest observed worldwide. While obstetric hemorrhage is often unpredictable, deterioration of heart disease is foreseeable. Attention should be directed specifically toward improving the diagnosis and treatment of maternal heart disease during pregnancy in Israel.

Sections du résumé

BACKGROUND BACKGROUND
Admission to an intensive care unit (ICU) is an objective marker of severe maternal morbidity (SMM).
OBJECTIVES OBJECTIVE
To determine the prevalence of obstetric ICU admissions in one medical center in Israel and to characterize this population.
METHODS METHODS
In this retrospective study the files of women coded for pregnancy, birth, or the perinatal period and admission to the ICU were pulled for data extraction (2005-2013).
RESULTS RESULTS
During the study period, 111 women were admitted to the ICU among 120,279 women who delivered babies (0.09%). Their average age was 30 ± 6 years, most were multigravida, a few had undergone fertility treatments, and only 27% had complicated previous pregnancies. Most pregnancies (71.2%) were uneventful prior to admission. ICU admissions were divided equally between direct (usually hemorrhage) and indirect (usually cardiac disease) obstetric causes.
CONCLUSIONS CONCLUSIONS
The indications for obstetrics ICU admission correlated with the proximate causes of maternal arrest observed worldwide. While obstetric hemorrhage is often unpredictable, deterioration of heart disease is foreseeable. Attention should be directed specifically toward improving the diagnosis and treatment of maternal heart disease during pregnancy in Israel.

Identifiants

pubmed: 32147977

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

142-147

Auteurs

Misgav Rottenstreich (M)

Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, affiliated with the Hebrew University Hadassah Medical School, Jerusalem, Israel.

Ortal Reznick (O)

Department of Pediatrics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.

Hen Y Sela (HY)

Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, affiliated with the Hebrew University Hadassah Medical School, Jerusalem, Israel.

Alexander Ioscovich (A)

Department of Anesthesiology, Shaare Zedek Medical Center, affiliated with the Hebrew University Hadassah Medical School, Jerusalem, Israel.

Sorina Grisaro Granovsky (S)

Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, affiliated with the Hebrew University Hadassah Medical School, Jerusalem, Israel.

Carolyn F Weiniger (CF)

Division of Anesthesia and Critical Care and Pain, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Sharon Einav (S)

Department of Intensive Care, Shaare Zedek Medical Center, affiliated with the Hebrew University Hadassah Medical School, Jerusalem, Israel.

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