A group of 15 physicians from Hospital da Luz Lisboa has recently published, in the scientific journal “Medicina”, a study on the motives that led pregnant or post-delivery women resorting to this hospital to require assistance and admission to intensive care. All the 150 cases reported between 2007 and 2022 were selected, thus comprising the most extensive study ever conducted in Portugal and one of the largest in Europe and providing valuable indicators on maternal health and mortality. The article is titled “Obstetric Intensive Care Admissions and Neonatal Outcomes: 15 Years of Experience from a Single Center” . The study was carried out by physicians in the specialties of Gynecology-Obstetrics, Internal Medicine, Intensive Medicine, and Neonatology – namely, Filipa Ramalho Rocha , Tiago Neto Gonçalves , Maria Inês Xavier-Ferreira , Francisco Laranjeira , Gonçalo Meleiro Magalhães , Maria Inês Lopes , Marta Sousa , Daniela Pestana , Élia Fernandes , Ana Chung , Ana Berdeja , Gonçalo Cassiano Santos , Natália Marto , António Messias and Jorge Lima . Added value of the research “Our study has significant strong points”, highlights Jorge Lima, coordinator of the study and head of Hospital da Luz Lisboa High-Risk Pregnancy Center . He further points out the main aspects: “First of all, we have examined a large number of cases, representing to our knowledge the most comprehensive cohort of the country and one of the largest in Europe. Secondly, our period of observation spanned over 15 years, considerably longer than many studies reported in the existing literature, allowing us to identify the motives leading to intensive care admission and to evaluate results in a more consistent manner”. Hospital da Luz Lisboa has registered in recent years an average of deliveries above 3,000, being presently one of the largest maternity hospitals in the country. “Morbidity and mortality are measures for assessing maternal healthcare, and admissions to intensive care (ICU) are indicators that can be used to analyze those metrics. Here, (…) admission-related variables and neonatal variables related with women admitted during pregnancy and up to 42 days post-delivery were examined”, explain the authors in the introduction of the article. “This study is one of the few national studies focused on obstetric intensive care admission and the first one conducted in a private hospital setting, offering a unique perspective on maternal morbidity in Portugal”, they stress. Among the main conclusions, we highlight the following: Over the 15-year period of the study, the Hospital da Luz ICU received 150 obstetric admissions involving 148 patients, in a total of 34,360 deliveries; Admissions to the obstetric ICU for this period represent approximately 0.9% of the adult admission total, with an admission rate of 4.4 per 1,000 deliveries ; The mean age for women admitted was 34 years, ranging from 21 to 54. Almost half (45%) of these women were over 35 , the older patients presenting higher admission rates, due to postpartum hemorrhage and having previous pregnancies and cesarean sections, compared to under-35 patients. However, there was no significant difference in hypertensive disorders between the two groups; Despite the demographic variations and social differences inherent to a cohort from private health care, the incidence and pattern of admission to ICU were similar to other cohorts, predominantly characterized by admission due to postpartum hemorrhage and pregnancy hypertensive disorders ; Compared to other cohorts and national records from developed countries, the patients here studied were typically more aged and with a lower prevalence of chronic disease related with pregnancy. However, an increased resort to reproduction medicine was observed; The specific needs of obstetric ICU patients stress the necessity of a specialized training of multidisciplinary teams. Severe postpartum hemorrhage was responsible for significant morbidity and disability, prompting a reassessment of the delivery practices. The article “ Obstetric Intensive Care Admissions and Neonatal Outcomes: 15 Years of Experience from a Single Center ” was published on the 25 November 2024.
