Pattern and Outcome of Obstetric Admissions Into the Intensive Care Unit of a South-east Nigerian Hospital [38R

Abstract

INTRODUCTION: Although pregnancy and labor are considered physiological processes, the potential for catastrophic complications is constant and may develop rapidly. There is growing evidence that admission of high risk patients into the intensive care unit is associated with a reduction in maternal mortality. This study was aimed at reviewing all obstetric patients admitted into the intensive care unit (ICU) of Federal Teaching Hospital, Abakaliki. METHODS: This was a retrospective study of all obstetric patients who were admitted into the ICU between January 1st 2012 and December 31st 2013. RESULTS: During the study period, there were 5176 deliveries. Over the same period there were 89 obstetric patients admitted and managed in the ICU, accounting for 1 in 58 deliveries. A total of 53 (59.0%) patients were between 21 and 30 years. The mean age was 28.4±5.8 years and most of the patients were primiparous. Two thirds of the patients were unbooked. The mean duration of admission was 4.5±3.2 days. All the patients were admitted at postpartum period. The most common indication for admission was ruptured uterus 32 (36.0%) with a case fatality rate of 18.8% and contributing 50% of the overall maternal mortality. There were 12 (13.5%) maternal deaths and booking status was significantly associated with maternal death (P = 0.046). CONCLUSION: The commonest indication for admission was ruptured uterus. Almost all the maternal mortalities were among unbooked patients. These maternal deaths can be prevented by booking for antenatal care and the presence of skill birth attendants at delivery.