| [Objective] to understand the disease distribution and treatment process of critically ill pregnant women,analyze the causes of critically ill pregnant women admitted to ICU,and summarize the experience of Obstetrics combined with ICU in rescuing critically ill pregnant women.In order to reduce the mortality of critically ill pregnant women and improve the prognosis of critically ill pregnant women.To enhance the ability of diagnosis and treatment and rescue of obstetric critical pregnant women.[Methods] the clinical data of pregnant and lying in women transferred to ICU in the first hospital of Jilin University from January 2015 to December 2019 were retrospectively analyzed.The general data of pregnant and lying in women and the disease distribution,pregnancy outcome and treatment process of critically ill pregnant and lying in women were collected.[Results]1.In recent five years,19144 cases of pregnant and lying in women were treated in obstetrics department,of which 201 cases were transferred to ICU,and the ICU transfer rate was 1.05%(201 / 19144);236 cases were transferred to ICU.2.Compared with the general situation of ICU patients,there were significant differences between the two groups in the timing of ICU transfer,weeks of termination of pregnancy,mode of delivery,causes of ICU admission,APACHE II score within 24 hours of ICU admission,length of ICU stay,total length of hospital stay,hospitalization expenses,and number of transferred cases of neonatal diseases(P< 0.05).3.The top three causes of critical pregnant women in ICU:(1)hypertensive disorder complicating pregnancy and related complications 32.5%(65/201)(hypertensive disorder complicating pregnancy preeclampsia;HELLP syndrome,eclampsia,etc.);(2)pregnancy complicated with heart disease 12.5%(25 / 201);(3)postpartum hemorrhage 9.5%(19 / 201).4.Among 201 cases of critical pregnant women,130 cases(64.7%)were obstetric factor group,71 cases(35.3%)were non obstetric factor group.The top three causes of diseases in the obstetric factor group were:(1)hypertensive disorder complicating pregnancy;(2)postpartum hemorrhage;(3)placenta previa.In the non obstetric factor group,the top three causes of diseases in ICU were:(1)pregnancy complicated with heart disease;(2)pregnancy complicated with rheumatic system disease;(3)chronic hypertension complicated with pregnancy.5.Comparing the general situation of obstetric factor group with non obstetric factor group,obstetric factor group was significantly higher than non obstetric factor group in elderly pregnant women,pregnant women with regular pregnancy examination,pregnant women with 28-37 weeks delivery and full-term delivery,and average length of ICU stay(P < 0.05);Non obstetric factors group < 28 weeks delivery was significantly higher than obstetric factors group,the difference was statistically significant(P < 0.05).The amount of blood loss and red blood cell transfusion within 24 hours after delivery in obstetric factor group were significantly higher than those in non obstetric factor group(P < 0.05).6.In ICU,14 cases of deep vein catheterization in obstetric factor group were significantly higher than those in non obstetric factor group(5 cases),the difference was statistically significant(P < 0.05).The number of invasive mechanical ventilation cases in non obstetric factor group was significantly higher than that in obstetric factor group,the difference was statistically significant(P < 0.05).7.Among 201 critically ill pregnant women transferred to ICU,the top three diseases with the longest average hospitalization days were:(1)acute fatty liver of pregnancy;(2)amniotic fluid embolism;(3)pregnancy complicated with pulmonary embolism.8.Among 201 critically ill pregnant women transferred to ICU,the top three diseases with the longest average hospitalization days were:(1)acute fatty liver of pregnancy;(2)amniotic fluid embolism;(3)pregnancy complicated with pulmonary embolism.The top three diseases that cost the most were:(1)acute fatty liver of pregnancy;(2)amniotic fluid embolism;(3)pregnancy complicated with acute pancreatitis.9.There were 157 cases in our hospital,99 cases in obstetric factor group and58 cases in non obstetric factor group.The number of cases of intrauterine fetal death,full-term birth and neonatal death in obstetric factor group was significantly higher than that in non obstetric factor group(P < 0.05),and the number of abortion cases in non obstetric factor group was significantly higher than that in obstetric factor group(P < 0.05).The average gestational age of the obstetric factor group was 35.32 ± 3.23,which was significantly smaller than that of the non obstetric factor group(P < 0.05). |
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