Skip to main content

Audit of obstetric critical care admissions in a high-risk population


South-east London (SEL) presents unique challenges to healthcare providers due to its diverse demographic. The high levels of poverty, immigration and psychiatric illness impact delivery of obstetric care. These were identified as risk factors for poor outcome in the latest CMACE report [1]. The Intensive Care National Audit and Research Centre (ICNARC) produced data on obstetric critical care admissions in 2007 [2]. We reviewed the obstetric critical care admissions in three SEL hospitals and compared this with the national average determined in the ICNARC and CMACE data.


All critical care admissions in three high-risk obstetric units in SEL (1 August 2009 to 31 July 2011) were screened for patients who were currently or recently pregnant. We compared local results with national data by ICNARC and CMACE.


There were 68 obstetric critical care admissions in the SEL hospitals within the audited time frame. The mean age was 30.05 in ICNARC data compared with 33.93 in SEL. Average APACHE II scores were lower in SEL compared with the ICNARC data, but length of stay was greater in SEL (2.72 days) compared with ICNARC (1.5 days). Haemorrhage was the most common reason for admission in SEL, whilst sepsis was the leading cause of death according to the latest CMACE report (Figure 1).

Figure 1

Causes for critical care admission in SEL, CMACE and ICNARC.


Data from national audits may guide protocol, but services must be tailored to local circumstances. SEL has unique population characteristics and obstetric critical care admissions differ significantly from national statistics; in particular, haemorrhage is over-represented in our region. Critical care services were generally required for a short period of time; during this period, routine postpartum care may be omitted as treatment priorities differ. Dedicated critical care services on the labour ward may be a way to combine postnatal care with transient high-dependency requirements. This may enhance patient experience and prove cost-effective.


  1. 1.

    Centre for Maternal and Child Enquiries: Saving mothers' lives: reviewing maternal deaths to make motherhood safer: 2006-08. The Eighth Report on Confidential Enquiries into Maternal Deaths in the United Kingdom. BJOG 2011, 118(Suppl 2):1-203.

    Google Scholar 

  2. 2.

    Female Admissions (Aged 16-50 Years) to Adult, General Critical Care Units in England, Wales and Northern Ireland, Reported as 'Currently Pregnant' or 'Recently Pregnant'[]

Download references

Author information



Corresponding author

Correspondence to K El-Boghdadly.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Cite this article

El-Boghdadly, K., Aron, J. & Onwochei, D. Audit of obstetric critical care admissions in a high-risk population. Crit Care 17, P509 (2013).

Download citation


  • Critical Care
  • National Average
  • Obstetric Care
  • Postnatal Care
  • Unique Population