FREQUENCY, CAUSES AND OUTCOME OF ACUTE KIDNEY INJURY IN CRITICALLY ILL OBSTETRIC PATIENTS ADMITTED TO INTENSIVE CARE UNIT OF A TERTIARY CARE HOSPITAL; A CASE SERIES

Nazia Liaqat; Wajeeha syed

doi:10.46903/gjms/23.4.1992

FREQUENCY, CAUSES AND OUTCOME OF ACUTE KIDNEY INJURY IN CRITICALLY ILL OBSTETRIC PATIENTS ADMITTED TO INTENSIVE CARE UNIT OF A TERTIARY CARE HOSPITAL; A CASE SERIES

Nazia Liaqat, Wajeeha syed

Abstract

Background: Acute kidney injury represents the commonest sequela of obstetric complications. It can potentially complicate the course of hospitalization and drastically worsens the outcomes of critically ill obstetric patients. It can influence both short-term and long-term prognosis. The current research aimed to find out burden of acute kidney injury (AKI)in obstetric patients, transferred to critical care unit, and to determine its association with outcome of these women.

Materials & Methods: A review of 62 critically ill women shifted to critical care unit, was carried out in a teaching hospital of Peshawar, from January 2021 to December 2021. All obstetric cases shifted to intensive care unit (ICU), either in pregnancy or postpartum within 42 days of having birth, were considered for the review. All the relevant detail including age, parity, status(pregnant/postpartum), booking status, mode of delivery, reason for ICU admission, presence or absence of AKI, other complications, outcome, need for ventilation etc. Were noted from hospital record. Cases lacking record on the above details were not included in the review.

Results: AKI was observed in 29(46.77%) of 62 obstetric intensive care admissions. Underlying obstetrical condition more commonly associated with AKI were Eclampsia and Postpartum hemorrhage (PPH), each accounting for 11 (37.99%) cases of AKI, followed by cardiac diseases seen, in 10.34% cases, placental abruption in 6.89% women. AKI showed statistically significant association with normal birth 21(72.41%) as compared to cesarean delivery 8(27.5%). p-0.01. A total of 17 (27.4%) women expired in ICU.Out of 17 cases who expired,13 (76.4%) had AKI. (p-0.004)

Conclusion: AKI is the commonest complication and is associated with elevated risk of in- hospital mortality in critically ill obstetric patients transferred to critical care unit.

Keywords

Acute kidney injury; Intensive care; Maternal death.

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DOI: https://doi.org/10.46903/gjms/23.4.1992