MATERNAL AND NEONATAL OUTCOMES IN HIGH-RISK PREGNANCIES: A RETROSPECTIVE ANALYSIS OF ICU ADMISSIONS

Abstract

Background: High-risk pregnancies requiring ICU admission pose significant challenges to maternal and neonatal health. This study analyzes the indications, interventions, and outcomes of obstetric ICU admissions to identify risk factors and improve management strategies.

Methods: A retrospective analysis was conducted on 35 high-risk pregnant women admitted to the ICU at a tertiary care center. Data on demographics, indications for ICU admission, maternal interventions, and neonatal outcomes were extracted from medical records. Univariate logistic regression identified risk factors for severe maternal outcomes (PPH, eclampsia, hysterectomy).

Results: Demographics: Mean age was 28.5 years; 62.9% were multigravidas, and 22.9% had prior cesarean deliveries. ICU Indications: Hypertensive disorders (45.7%) and PPH (28.6%) were the leading causes. Interventions: 51.4% required blood transfusions, 14.3% needed mechanical ventilation, and 11.4% underwent hysterectomy. Neonatal Outcomes: 40% were preterm, 35.7% had low birth weight, and 21.4% required NICU admission. Risk Factors: Hypertensive disorders (OR 4.2, *p*=0.016) and prior cesarean (OR 3.8, *p*=0.032) significantly predicted severe outcomes.

Conclusion: Hypertensive disorders and PPH are the primary drivers of obstetric ICU admissions, with prior cesarean delivery and twin pregnancies amplifying risks. Despite high morbidity, timely interventions (e.g., transfusions, MgSO₄) prevented maternal mortality. Preterm birth and low neonatal weight remain critical concerns. The findings advocate for:

1. Enhanced prenatal monitoring of high-risk pregnancies,
2. Protocolized hemorrhage management, and
3. Multidisciplinary ICU care models.