Characteristics of consultations outside the maternal ICU associated with ICU admission and “Near Miss” events in obstetric patients

• Autor: Paredes Saravia, Lourdes Maria
• Formato: artículo
• Fecha de Publicación: 2024
• Institución: Instituto Nacional Materno Perinatal
• Repositorio: Revista Peruana de Investigación Materno Perinatal
• Lenguaje: español
• OAI Identifier: oai:investigacionmaternoperinatal.inmp.gob.pe:article/423
• Enlace del recurso: https://investigacionmaternoperinatal.inmp.gob.pe/index.php/rpinmp/article/view/423
• Nivel de acceso: acceso abierto
• Materia: indicador de morbimortalidad; obstetricia; unidades de cuidados intensivos; Complicaciones del Embarazo; Near Miss; Maternal mortality; maternal intensive care; obstetric patients; Extreme maternal morbidity

Introduction: Consultations outside the Maternal Intensive Care Unit (ICU) enable early identification of critical complications in obstetric patients, preventing clinical deterioration. Objective. To identify the characteristics of non-ICU consultations and their relationship with maternal Near Miss events. Methods: An observational, correlational, and retrospective study was conducted, including 768 patients assessed outside the ICU at the Instituto Nacional Materno Perinatal between January and December 2022. Sociodemographic and clinical variables were collected. Bivariate and multivariate analyses were performed to evaluate the association between organ dysfunctions and the outcomes of Near Miss events and ICU admission. Adjusted risk ratios (RR) with 95% confidence intervals (CI95%) were estimated. A p-value <0.05 was considered statistically significant. Results: A total of 54% of the patients experienced Near Miss events. The main causes were hypertensive disorders (46%) and hemorrhages (23%). Respiratory dysfunctions (adjusted OR: 6.36; CI95%: 3.96–10.23) and electrolyte imbalances (adjusted OR: 3.17; CI95%: 2.07–4.87) were significantly associated with ICU admission. Direct ICU referral showed the strongest association with this outcome (adjusted RR: 2.16; CI95%: 1.80–2.60; p<0.001). Conclusion: Outpatient consultations play a crucial role in the identification of obstetric complications. Early detection of Near Miss events optimizes clinical management and reduces maternal morbidity and mortality, highlighting the need for structured protocols and surveillance tools.