Analysis of Morbidity and Mortality in the Obstetrical Intensive Care Unit (UCIO) April 2009 / December 2016

Se comenta la experiencia de 10 años en cuanto a la morbilidad y mortalidad de pacientes obstétricas en una unidad de cuidados intensivos.Objectives: To determine the rate of admission to an obstetrical Intensive Care Unit (O-ICU), maternal mortality rate and the main factors associated with it. Methods: This was a retrospective study, analyzing all the admission to an O-ICU between January 1, 2009, and november 28, 2016. The registries were completed since the first day of recruitment until discharge or death. Results: Among 2,145 patients admitted to the O-ICU during the study period, maternal mortality was of 4.6% (n = 100). The three main causes of hospitalization were hypertensive disorders (47.1%), bleeding disorders (18.9%) and infectious complications (5.4%). The Receiver Operating Characteristic (ROC) curve showed the patient’s age was the variable with the largest area under the curve (0.569) in relation to mortality. Applying the linear regression model gave as a result that age, Mean Arterial Pressure (MAP), platelets at admission and haemoglobin are significant (P ≤ 0.001) as predictive factors for mortality. The Weight Estimation test also showed significance for platelets count and MAP at admission. Conclusion: From the analysis done, it showed that the patient’s age, MAP and platelets at admission are the most important parameters to predict mortality

Sclerotherapy with 6% polidocanol solution in patients with placenta accreta

Objective: Placenta accreta is one of the main obstetrical complications worldwide. The aim of this study was to report the experience of managing placenta accreta with a 6% polidocanol solution sclerotherapy. Materials and Methods: We selected patients between 37 weeks of gestation and 38 weeks of gestation, diagnosed with placenta accreta, treated at the Maternal Perinatal Hospital “Monica Pretelini Sáenz”, Toluca, Mexico, during the period from November 2013 to August 2014. The surgical technique has two steps: (1) fundic-arciform caesarean section followed by a 6% polidocanol sclerosing solution through a 6Fr neonatal feeding tube upon its reaching the placental bed; (2) total abdominal hysterectomy with internal hypogastric artery ligation. Results: Data were collected from 11 patients with a mean age of 33.9 years (range, 26e42 years) and 2.8 ± 0.6 days of hospitalization in the obstetrical intensive care unit. The majority of patients were classified as having pregnancies at an advanced age. All women were multigravidas. Bleeding volume exhibited a range between 2.5 L and 3 L without any case of neonatal death but one mother died because of coagulopathy. Conclusion: We conclude that the technique that we are reporting is feasible for implementation in obstetric hospitals, with technical and economic feasibility

Analysis of Morbidity and Mortality in the Obstetrical Intensive Care Unit (UCIO) April 2009 / December 2016

Se comenta la experiencia de 10 años en cuanto a la morbilidad y mortalidad de pacientes obstétricas en una unidad de cuidados intensivos.Objectives: To determine the rate of admission to an obstetrical Intensive Care Unit (O-ICU), maternal mortality rate and the main factors associated with it. Methods: This was a retrospective study, analyzing all the admission to an O-ICU between January 1, 2009, and november 28, 2016. The registries were completed since the first day of recruitment until discharge or death. Results: Among 2,145 patients admitted to the O-ICU during the study period, maternal mortality was of 4.6% (n = 100). The three main causes of hospitalization were hypertensive disorders (47.1%), bleeding disorders (18.9%) and infectious complications (5.4%). The Receiver Operating Characteristic (ROC) curve showed the patient’s age was the variable with the largest area under the curve (0.569) in relation to mortality. Applying the linear regression model gave as a result that age, Mean Arterial Pressure (MAP), platelets at admission and haemoglobin are significant (P ≤ 0.001) as predictive factors for mortality. The Weight Estimation test also showed significance for platelets count and MAP at admission. Conclusion: From the analysis done, it showed that the patient’s age, MAP and platelets at admission are the most important parameters to predict mortality