Obstetric Patients Requiring Intensive Care: Prevalence, Clinical Characteristics and Outcome in a Tertiary Care Institute in Nigeria

Abstract

Maternal mortality is a major health problem in developing countries. Critical care of the obstetric patient has been recognized as a useful tool in the reduction of maternal morbidity and mortality. The study is a five year retrospective review of the clinical characteristics and outcome of all obstetric admissions into the ICU. Data collected and analyzed included demographics, diagnosis at admission, mode of delivery, ante natal booking status, duration of admission into the ICU, mechanical ventilatory support, duration of stay on the ventilator and outcome of ICU admission. There were 170 obstetric admissions accounting for 25.3% of total ICU admissions during the period of review. The mean age of patients was 30.2±29.2 years. Hypertensive disorders of pregnancy accounted for the highest cause of obstetric admission diagnosis 51.7%. Majority of the patients 94.7% were admitted postpartum. The mean length of ICU stay was 2.7 ± 2.8days. Mortality was 26.5% with a significantly higher percentage of deaths in unbooked/referred patients (66.7%). There is a high rate of ICU admission of obstetric patients in our hospital. Mortality is also high especially among unbooked late referrals. Timely referrals and early recourse to ICU care by booked patients may provide some improvement in the standard of care received in the ICU with a subsequent lower mortality.