Behavior of grave obstetric patient. Experiences of four- year work

Abstract

Nowadays there is preoccupation not only with the complications of diseases associated with pregnancy that may lead women to a grave status, but also those complications related with childbirth. Our objective was to study the morbimortality caused by serious obstetric complications in four-year work. We studied 83 patients with serious obstetric complications attended at the Intensive Care Unit of the General Teaching Hospital “Julio M. Aristegui Villamil”, of Cardenas, in the period from January 2003 to December 2006, representing 100 % of the patients entered for this cause in the service. We observed more quantity of cesarean surgery in 2005, in correspondence with a bigger number of pregnant patients with associated pathologies. For that reason we decided the abdominal childbirth. Hypertension was a preoccupant complication, but the number of patients entered by that reason was low per year. Sepsis explained the importance of the complications appeared in 30 % of our patients. The results indicated a higher relation between via vaginal childbirth and seriousness. In 2004 and 2005 there was a less number of interventions, and severe septic metritis was always the predominant cause of radical surgery. 38.5 % of the patients received automatic ventilation, and 71.8 % of them were ventilated less than 72 hours. The staying in the Intensive Care Unit was long to secure the optimal recuperation of the patients. Serious obstetric complications are still a challenge. The four-years-work results are an expression of the integrally optimal management in our settings.