Please cite this article in press as: Seppänen P, et al. Obstetric admissions to ICUs in Finland: A multicentre study. Intensive
Crit Care Nurs (2016), http://dx.doi.org/10.1016/j.iccn.2016.03.002
ARTICLE IN PRESS
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YICCN-2435; No. of Pages 7
Intensive and Critical Care Nursing (2016) xxx, xxx—xxx
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ORIGINAL ARTICLE
Obstetric admissions to ICUs in Finland:
A multicentre study
Pia Seppänen
a,*
, Reijo Sund
d
, Mervi Roos
a
, Riitta Unkila
b
,
Merja Meriläinen
e
, Mika Helminen
a,c
, Tero Ala-Kokko
e
,
Tarja Suominen
a
a
University of Tampere, School of Health Sciences, FI-33014 University of Tampere, Finland
b
Tampere University Hospital, Intensive Care Unit, PO BOX 2000, FI-33521 Tampere, Finland
c
Science Centre, Pirkanmaa Hospital District, PO BOX 2000, FI-33521 Tampere, Finland
d
Centre for Research Methods, Department of Social Research, University of Helsinki, PO BOX 54,
FI-00014 University of Helsinki, Finland
e
Oulu University Hospital, PO BOX 21, FI-90029 Oulu, Finland
Accepted 16 March 2016
KEYWORDS
Adverse event;
Interventions;
Obstetric patient;
Outcome;
Severity of illness
Summary In this study, the objective was to describe and analyse reasons for obstetric
admissions to the ICU, severity of illness, level and types of interventions, adverse events
and patient outcomes. In a retrospective database study, we identified 291 obstetric patients
during pregnancy and puerperium from four Finnish university hospitals. Most were admitted in
the post-partum period and hypertensive disorders were the main indications for admissions,
followed by obstetric haemorrhage. The median length of stay was 21 hours. The most common
intervention was blood transfusion and mechanical ventilation was required in nearly one fifth
of the patients. Three patients had a prolonged stay and nine had re-admissions. One maternal
death was recorded. This study found that severity of illness and organ failure scores describe
the obstetric patient as having a good probability of recovery and a short length of stay. How-
ever, the obstetric patients reason for admission and their type of delivery were associated
with both the severity of illness scores and level of intervention required. Those admitted for
non-obstetric reasons and having had a vaginal delivery demonstrated higher severity of ill-
ness scores, organ failure scores, and levels of intervention when compared to those admitted
for obstetric reasons or those who had delivered by caesarean section. In conclusion, care of
these patients can be improved by understanding the severity of illness scores, common ICU
interventions and patient outcomes.
© 2016 Elsevier Ltd. All rights reserved.
∗
Corresponding author. Tel.: +358 452588333.
E-mail addresses: seppanen.pia.m@student.uta.fi (P. Seppänen), reijo.sund@helsinki.fi (R. Sund), mervi.roos@uta.fi (M. Roos),
riitta.unkila@pshp.fi (R. Unkila), merja.merilainen@ppshp.fi (M. Meriläinen), mika.helminen@uta.fi (M. Helminen), tero.ala-kokko@ppshp.fi
(T. Ala-Kokko), tarja.suominen@uta.fi (T. Suominen).
http://dx.doi.org/10.1016/j.iccn.2016.03.002
0964-3397/© 2016 Elsevier Ltd. All rights reserved.