Introduction: Critically ill obstetrics patients represent an interesting group with unique characteristics whose management is challenged by the presence of a fetus an altered maternal physiology and disease specific to pregnancy. Although pregnancy and labour are considered physiological processes, the potential for catastrophic complications is constant and may develop within minutes.

To every maternal death, there are about 18 maternal morbidities and maternal mortality and morbidity are a measure of health care quality indices in any given community.

Objectives: 1. To find out the incidence of SAMM. 2. To study outcome of obstetric ICU admitted patients.

Methods: Hospital files of all obstetric patients admitted to the Kamla Raja Hospital ICU from 2017 to 2018 were retrospectively reviewed. Age, parity, admission, diagnosis, length of stay, information on the referring hospitals and maternal outcome were analysed.

Result: Total 1713 obstetric patients were admitted in the ICU during the study period. Hypertensive disorder of the pregnancy was the commonest cause for ICU admission. Maximum no. of SAMM cases 113(44.84%) were in 20-30 years. Maximum no. of SAMM cases were multigravida 166(65.87%). Out of total 252 cases 156(61.9%) cases were unbooked. In this study, LSCS as surgical management in 190(75.39%) cases followed by laparotomy 13(5.138%).

Conclusion: Provision of HDU in the Obstetric Department is helpful to reduce burden of ICU admission. All obstetric residents should have a mandatory short ICU training.

1. Kesava Chandra G, Vijaya Lakshmi D. Critical care in obstetrics-a retrospective one year study in tertiary care hospital from August 2015 to July 2016. Paripex - Indian Journal Of Research. 2017;6(11):43-44.
2. Sinha M, Goel JK, Sah S, Goel R, Chaurasia R. Severe acute maternal morbidity: study of epidemiology and risk factors. Int J Reprod Contracept Obstet Gynecol 2016;5:2141-5.
3. Say L, Souza JP, Pattinson RC. Maternal near miss towards a standard tool for monitoring quality of maternal health. Best Prac Res Clin Obstet Gynaecol 2009;23:287-296.
4. Akker T, Rhenen JV, Mwagomba B, Lommerse K, Vinkhumbo S, Roosmalen JV. Reduction of severe acute maternal morbidity and maternal mortality in thyolo district, Malawi: The impact of obstetric adult. PLoS One. 2011;6(6):e20776.
5. Ronsmans C, Fillipe V. Beyond the numbers reviewing maternal deaths and complications to make pregnancy safer, Geneva, Switzerland: world organization: Reviewing severe maternal morbidity: learning from survivors from life threatening complications: 2004:103-24.
6. Pattinson RC, Buchmann E, Mantel G, Schoon M, Rees H. Can enquiries into severe acute maternal morbidity act as a surrogate for maternal death enquiries BJOG. 2003;110:889-93.
7. Filippi V, Brugha R, Browen E, Gohou V, Bacci A, De Brouwere V. Obstetric audit in resourse-poor settings: Lessons from a multi-country projest auditing near miss obstetrical. Health Policy Plan. 2004 Jan;19(1):57-66.
8. Wilson RE, Salihu HM. The paradox of obstetric "near misses": converting maternal mortality into morbidity. Int J Fertil Womens Med 2007;52(2-3):121-7.
9. Khan KS, Wojdyla D, Say L, Gülmezoglu AM, Van Look PF. WHO analysis of causes of maternal death: a systematic review. Lancet. 2006;367(9516):1066-74.
10. Rajaram P, Agrawal A, Swain S, Determinants of maternal mortality. A hospital based study from south india. Indian J Matern Child Health. 1995;6:7-10.

Dr Km. Deepika

Senior Resident Department of Obstetrics and Gynaecology, Gajra Raja Medical College, Gwalior, MP, India