Analysis On 219 Cases Of Critically Ill Obstetric Patients Cured By Combination Of Obstetrics And ICU

Objective:This thesis summarized the clinical experience of Obstetrics combined with ICU in the treatment of critically ill obstetric patients by analyzing their disease distribution,diagnosis and treatment measures,treatment effect and pregnancy outcomes of intensive care unit(ICU).It not only provided a clinical reference for how to reduce the morbidity and mortality of critical pregnant women and perinatal infants,but also provided clinical data for how to standardize the treatment of critical pregnant womenMethods:The clinical data for 219 cases of critically ill obstetrics patients who were transferred from the Department of Obstetrics to Intensive Care Unit(ICU)at the First Affiliated Hospital of Kunning Medical University from January 2015 to December 2018 were retrospectively analyzed.After collecting the general clinical data,treatment and prognosis information of mothers and infants,the pregnant women were divided into pregnancy complications group and pregnancy induced hypertension group according to their past medical history and abnormalities during pregnancy.The disease characteristics and maternal-fetal outcomes were assessed,summed up and compared between the two groups.Results:1.The overall rate of admission into ICN was 0.78%(219/27910);Among 219 critically ill obstetric patients,140 cases(63.93%)were pregnancy complications group and 79 cases(36.07%)were pregnancy induced hypertension group.2.The top three diseases of critically ill obstetric patients in ICU were:?Postpartum hemorrhage;?Pregnancy-induced hypertension and related complications;? Pregnancy complicated with heart disease.The top 3 frequent obstetric reasons for admission to an ICU of pregnancy complications group were:?Postpartum hemorrhage;? Pregnancy-induced hypertension and related complications;:Puerperal infection.The top 3 frequent obstetric reasons for admission to an ICU of pregnancy induced hypertension grpup were:?Pregnancy complicated with heart disease;? Pregnancy complicated with acute abdominal diseases;?Pregnancy complicated with severe pneumonia.3.The three diseases with minimum duration of stay in hospital were as follows:? Postpartum hemorrhage;? Pregnancy-induced hypertension and related complications;?Pregnancy complicated with heart disease;The three diseases with the longest average length of stay in ICU were mainly:?Pregnancy complicated with acute abdominal diseases;?Pregnancy complicated with systemic lupus erythematosus;? Pregnancy complicated with cerebrovascular disease.4.Compared the general situation of pregnancy complications group with pregnancy induced hypertension group,there were significant differences in average age,average gravidity and parity history,terminated gestational week,and number of standardized Antepartum examination between the two groups(P<0.05);Compared the delivery situation between pregnancy complications group with pregnancy induced hypertension group,there were significant differences in anesthesia mode,delivery mode,24-hour postpartum hemor:rhage,number of interventional therapy and number of Bakri's balloon placement cases between the two groups(P<0.05).Compared the treatment situation of ICU between pregnancy complications group with pregnancy induced hypertension group,there were significant differences in ICU admission,the ICU-begin moment,number of ventilator treatments,quantity of blood products used(P<0.05).Compared the treatment outcomes between pregnancy complications group with pregnancy induced hypertension group,there were significant differences in the number of re-laparotomy cases,hysterectomy cases,shock cases,against medical ad and death cases between the two groups(P<0.05).5.Among 219 critically ill obstetric patients,39(17.80%)had multiple organ or system failure,including 19 cases of pregnancy complications group and 20 cases of pregnancy induced hypertension group,the difference was statistically significant(P<0.05).The occurrence of respiratory failure,renal failure and circulatory failure in the two groups was compared,and the difference was statistically significant(P<0.05).6.The coagulation function,fibrinolysis function,liver and kidney function and arterial blood gases of critically ill obstetric patients were compared when they were admitted to ICU and 48 hours after ICU treatment,the difference was statistically significant(P<0.05).Conclusion:1.At present,the main diseases of obstetric patients admitted to ICU are postpartum hemorrhage,hypertensive disorder of pregnancy and pregnancy complicated with heart disease.2.Critically ill obstetric patients who are transferred to ICU mainly suffer from pregnancy complications.With the increase of gravidity and parity history,they are prone to have postpartum hemorrhage and pregnancy-induced hypertension.The illness is ferocious.However,if timely treatment is given,the condition will improve quickly and the prognosis will be good.There are few cases of multiple organ failure and death.3.Combination of Obstetrics and intensive care unit(ICU)is an important measure to treat and cure critically ill obstetric patients in modern obstetrics.Starting the treatment of combination as soon as possible is a significant guarantee for maternal and neonatal life safety4.Standard prenatal care is the fundamental measure than protects the mother and the fetus,increases infant safety,and reduces morbidity and mortality?5.Establishment of ICU for obstetrics is the trend of modern obstetrics development.