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Near-miss maternal mortality: cardiac dysfunction as the principal cause of obstetric intensive care unit admissions.

Publication ,  Journal Article
Small, MJ; James, AH; Kershaw, T; Thames, B; Gunatilake, R; Brown, H
Published in: Obstet Gynecol
February 2012

OBJECTIVE: Evaluation of "near-miss" maternal mortality is a robust surveillance method to assess the quality of obstetric care and determinants of poor maternal outcome. To evaluate near-miss maternal mortality, we examined patient characteristics and maternal and neonatal outcomes for an obstetric population admitted to intensive care units (ICUs) in a tertiary care center. METHODS: Pregnant and postpartum patients admitted to Duke University Medical Center ICUs from January 2005 to April 2011 were enrolled. Demographic, diagnostic, and outcome data were abstracted from the medical records for analysis. RESULTS: A total of 86 women were included in the study. No participants were included more than once. The mean maternal age (±standard deviation) was 29.8±7.2 years. When racial and ethnic differences were examined, African American women were more likely to be admitted to the ICU. Significant ethnic differences in body mass index (BMI) were noted with African American women (mean BMI 35) and Hispanic women (mean BMI 36) having significantly higher BMIs than white women (mean BMI 28). The majority of patients (87%) were admitted postpartum. The mean length of stay was 10 days. The leading reason for admission to the ICUs was maternal cardiac disease (36%) followed by complications from hemorrhage (29%), sepsis (9%), and hypertensive disorders (9%). No significant racial or ethnic differences in maternal medical comorbidities or neonatal outcome were noted. CONCLUSION: In this obstetric population, the leading reason for ICU admissions was cardiac disease. The increasing prevalence of advanced maternal age, congenital heart disease, obesity, diabetes, and hypertension among women who are of childbearing age may be contributing factors. LEVEL OF EVIDENCE: III.

Duke Scholars

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Published In

Obstet Gynecol

DOI

EISSN

1873-233X

Publication Date

February 2012

Volume

119

Issue

2 Pt 1

Start / End Page

250 / 255

Location

United States

Related Subject Headings

  • Young Adult
  • Sepsis
  • Pregnancy Complications
  • Pregnancy
  • Population Surveillance
  • Patient Admission
  • Parity
  • Obstetrics & Reproductive Medicine
  • Maternal Mortality
  • Length of Stay
 

Citation

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Small, M. J., James, A. H., Kershaw, T., Thames, B., Gunatilake, R., & Brown, H. (2012). Near-miss maternal mortality: cardiac dysfunction as the principal cause of obstetric intensive care unit admissions. Obstet Gynecol, 119(2 Pt 1), 250–255. https://doi.org/10.1097/AOG.0b013e31824265c7
Small, Maria J., Andra H. James, Trace Kershaw, Betty Thames, Ravi Gunatilake, and Haywood Brown. “Near-miss maternal mortality: cardiac dysfunction as the principal cause of obstetric intensive care unit admissions.Obstet Gynecol 119, no. 2 Pt 1 (February 2012): 250–55. https://doi.org/10.1097/AOG.0b013e31824265c7.
Small MJ, James AH, Kershaw T, Thames B, Gunatilake R, Brown H. Near-miss maternal mortality: cardiac dysfunction as the principal cause of obstetric intensive care unit admissions. Obstet Gynecol. 2012 Feb;119(2 Pt 1):250–5.
Small, Maria J., et al. “Near-miss maternal mortality: cardiac dysfunction as the principal cause of obstetric intensive care unit admissions.Obstet Gynecol, vol. 119, no. 2 Pt 1, Feb. 2012, pp. 250–55. Pubmed, doi:10.1097/AOG.0b013e31824265c7.
Small MJ, James AH, Kershaw T, Thames B, Gunatilake R, Brown H. Near-miss maternal mortality: cardiac dysfunction as the principal cause of obstetric intensive care unit admissions. Obstet Gynecol. 2012 Feb;119(2 Pt 1):250–255.

Published In

Obstet Gynecol

DOI

EISSN

1873-233X

Publication Date

February 2012

Volume

119

Issue

2 Pt 1

Start / End Page

250 / 255

Location

United States

Related Subject Headings

  • Young Adult
  • Sepsis
  • Pregnancy Complications
  • Pregnancy
  • Population Surveillance
  • Patient Admission
  • Parity
  • Obstetrics & Reproductive Medicine
  • Maternal Mortality
  • Length of Stay