Clinical Profile and Outcomes of Obstetric Admissions to the High Dependency Unit in a Tertiary Care Hospital in Kolkata, India: A Prospective Observational Study

Introduction: Despite substantial reductions in global and national maternal deaths, obstetric complications remain a crucial cause of maternal morbidity and mortality, especially in low- and middle-income countries. These women require early admission and appropriate management in the High Dependency Unit (HDU). Evaluating obstetric admissions to the HDU is a vital approach for monitoring critically ill women during pregnancy in a tertiary care facility. Aim: To investigate the indications for obstetric admissions to the HDU, the various interventions required in the HDU and the final maternal outcomes in terms of morbidity and mortality. Materials and Methods: This prospective observational study included all 485 obstetric patients admitted to the HDU over an 18-month period at a tertiary care hospital in Kolkata West Bengal, India. The study assessed outcomes related to the patients’ age, booking status, past obstetric history, preexisting medical disorders, complications during the current pregnancy and interventions performed in the HDU. Outcomes were evaluated in terms of recovery, discharge from the HDU, need for transfer to the Critical Care Unit (CCU) and maternal deaths. Results: A total of 485 women experienced life-threatening conditions that necessitated admission to the HDU during the study period. Among these women, 285 (58.76%) belonged to the age group of 20–29 years, and 164 (33.81%) were booked patients admitted in an emergency. Among the complications, acute kidney injury following caesarean section and postpartum haemorrhage (PPH) were observed in 17.07% of cases each. The most common indication for HDU admission was eclampsia with uncontrolled seizures, which accounted for 81 (16.70%) of cases. Of the 485 admissions, 41 (8.45%) resulted in mortality. Conclusion: Among the 485 women admitted to the HDU, 85.36% recovered, 6.19% required a higher level of care, and 6.80% died. This study underscores the importance of access to the HDU for effectively managing and preventing morbidity and mortality in critically ill obstetric patients.