¹ Intensive Care Unit, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria, Australia 3168

Aims: Limited information exists regarding rapid response team (RRT) calls to obstetric patients, despite calls for routine adoption of obstetric early warning scores.(Lewis, 2007) We sought to examine the demographics and outcomes of intensive care unit (ICU) led rapid response team calls to obstetric patients in a large multispecialty hospital with a large obstetrics unit.

Methods: Details of calls to pregnant and post-partum patients were obtained from the hospital RRT database. Each call was retrospectively examined looking at patient demographics, reason for call, interventions and outcomes. Obstetric specific escalation calls such as urgent caesarian section (Code Pink/Green: not requiring maternal physiological instability and not involving the ICU based team) were excluded.

Results: 112 calls were logged during 43 months, with 96 calls analysed (11 Code Blue, 85 Medical Emergency Team (MET) calls). 32% of calls were to women currently pregnant. Of calls to post-partum women, 49% occurred 24 hours or more post delivery. The commonest reason for calling the RRT was hypotension, followed by decreased Glasgow Coma Score (GCS) and concern about patient. 69% of calls resulted in the woman remaining on the ward, with approximately 13% of calls necessitating direct intensive care admission. Of all women who received a RRT call, 23% had an ICU admission at some time during their hospital stay. There was one maternal and three neonatal deaths during the study period.

Conclusion: RRT calls using standard adult physiological calling criteria appear to successfully identify deteriorating obstetric patients. In centres that employ specific obstetric escalation systems, generic RRT calls may provide a second ‘safety net’ for these women.