Peripartum intensive care

Objective. To determine the prevalence rate of intensive care unit (ICU) admissions in Hospital Corporation of America (HCA) hospitals and further delineate indications and outcomes in a retrospective review at one such hospital. Study Design. Diagnosis-related group and revenue codes were combined to calculate maternity admissions to the ICU in HCA hospitals. Prospectively logged maternal admissions were retrospectively reviewed for calendar years 2004-2008 at Presbyterian/St. Luke's Medical Center (PSL) using inpatient medical records. Results. The prevalence rate of peripartum ICU admissions in HCA hospitals among 602,488 deliveries was 0.41%. At PSL, a high-acuity maternal fetal service, the occurrence of ICU admissions was 0.62%. Leading indications were hemorrhage and preeclampsia/eclampsia; multiples were over-represented, 20% required hysterectomy and nearly one-third of the patients were ventilated. Conclusions. The full scope of ICU resources should be available to the obstetric patient as the maternal requirement for such care is not rare.