Analysis Of Clinical Characteristics Of Critical Pregnant Women In ICU Of Three As Hospital In Northern Guizhou

Objective: This study describes the case data of critically ill pregnant women admitted to intensive care unit(ICU)from January 2010 to December 2020,and analyzes their clinical characteristics,so as to strengthen management and early intervention measures for major pregnancy complications/complications,and reduce the incidence of adverse outcomes of critically ill pregnant women.Methods: The clinical data of 916 critically pregnant and parturients admitted to ICU in our hospital from January 2010 to December 2020 were collected.According to the implementation time of China’s population policy change,the pregnant and parturients were divided into two groups: group A: January 01,2010 solstice December 31,2015;group B: On December 31,2020,the clinical characteristics of critically pregnant women before and after the two-child policy were compared.By collecting the medical records of 916 cases of critically pregnant and parturient women in hospital,Including age,gestational age,pregnancy,childbirth time,production time,prenatal,childbirth way,births,hysterectomy,pure drug therapy,interventional therapy,the bleeding,bleeding,blood transfusion amount,into the ICU diagnosis,main reason in the ICU,ICU hospitalization days,the main treatment measures,such as the main cause of death in patients with death,Excel is adopted to establish the database and finishing.SPSS18.0 software was used for data analysis.Kolmogorov-Smirov test was used to test the normality of quantitative data.Data conforming to normal distribution were expressed as mean ± standard deviation(x±s),while non-normal distribution data were expressed as median(range),number of cases or percentage.The t-test of two independent sample means was used for comparison between groups.The non-normally distributed data were compared between groups using Mann-Whitney U test.Qualitative data were compared between groups using chi-square test.P<0.05 was considered statistically significant.Results: 1.During the study period,there were 916 cases of critically pregnant and parturient women admitted to ICU in our hospital.The youngest age was 15,the oldest was 47,and the average age was 29.6±6.1 years old.The average gestational age was 36.0±6.7 weeks,and the average length of stay in ICU was 4.23±2.34 days.Most of them were from rural areas(64.19%,588/916).Before admission,272 cases(26.69%,272/916)received regular obstetric examination,and 607 cases(66.27%,607/916)did not receive regular obstetric examination.There were 30 cases(3.28%,30/916)who were not examined.They were mainly admitted to ICU after delivery(99.24%,909/916).The most common delivery mode was cesarean section(83.84%,768/916),113 cases(12.34%,113/916)underwent hysterectomy.56 cases of interventional therapy(6.11%,56/916),30 cases of uterine suture(3.28%,30/916),Uterine artery ligation(2.95%,29/916),intrauterine tamponade(2.51%,23/916),abdominal aortic balloon occlusion(1.86%,17/916)and iliac artery ligation(0.55%,5/916)were applied in the treatment of critically serious pregnant women with postpartum hemorrhage.There were 37 cases of stillbirth(4.04%,37/916)and86 cases of induced labor and abortion(9.39%,86/916).2.Among them,774 cases were admitted to the ICU for obstetric reasons and 473 cases were admitted to the ICU for non-obstetric reasons.Among them,301 cases of hypertension during pregnancy,258 cases of postpartum hemorrhage,and 224 cases of pregnancy complicated with heart disease.3.After the implementation of the two-child policy,the age of critically pregnant women increased,the length of stay in ICU extended,the proportion of mechanical ventilation increased,the proportion of hysterectomy was higher,and the proportion of pregnancy hypertension and scar uterus was higher.4.Pregnancy outcome: 48 maternal deaths(5.24%,48/916).In addition,13 pregnant women were asked to sign out of the hospital for family reasons.After active treatment,22 critically ill pregnant and parturient women asked to return to local hospitals for treatment,and 883 pregnant and parturient women were successfully treated.Conclusion: The main reasons for critically pregnant women to be admitted to ICU were hypertension during pregnancy,postpartum hemorrhage and pregnancy combined with heart-related diseases.The top three causes of death of critically pregnant women were postpartum hemorrhage combined with DIC,heart disease combined with severe pulmonary hypertension,pregnancy induced hypertension combined with cerebrovascular accident.The primary cause of death of critically pregnant women was postpartum hemorrhage.MDT teamwork has improved the success rate of treatment.