Pattern and outcome of obstetric admissions into the intensive care unit of a Southeast Nigerian Hospital
Benjamin Ozumba, Leonard Ajah, Vitus Obi, Uche Umeh, Joseph Enebe, Kingsley Obioha
Critical obstetric cases, Intensive Care Unit, obstetric admissions, South-East Nigeria
Citation Information :
Ozumba B, Ajah L, Obi V, Umeh U, Enebe J, Obioha K. Pattern and outcome of obstetric admissions into the intensive care unit of a Southeast Nigerian Hospital. Indian J Crit Care Med 2018; 22 (1):16-19.
Background and Aims: 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 (ICU) is associated with a reduction in maternal mortality. This study was aimed at reviewing all obstetric patients admitted into the ICU.
Materials and Methods: This was a retrospective study of all obstetric patients who were admitted into the ICU between January 1, 2012, and December 31, 2013.
Results: There were 89 obstetric patients admitted and managed at the ICU out of 5176 deliveries, thereby accounting for 1 admission in 58 deliveries. Majority of the patients were between 26 and 30 years, primiparous, and unbooked. The indications for ICU admission in this study were ruptured uterus (36.0%), eclampsia (22.5%), obstetric hemorrhage (19.1%), septicemia (10.1%), severe preeclampsia (6.7%), and obstructed labor (6.7%). The maternal and perinatal mortality was 13.5% and 47.2%, respectively. Maternal unbooked status was significantly associated with maternal mortality (P &FNx01#60; 0.05).
Conclusion: Ruptured uterus was the most common indication for ICU admission in the center. Maternal mortality was significantly associated with unbooked status. This underscores the importance of booking for antenatal care, prompt presentation at the hospital during emergencies, skilled birth attendance, and provision of adequate facilities for the management of critical obstetric cases in this environment.
Dattaray C, Mandal D, Shankar U, Bhattacharya P, Mandal S. Obstetric patients requiring high-dependency unit admission in a tertiary referral centre. Int J Crit Illn Inj Sci 2013;3:31-5.
Faponle AF, Adenekan AT. Obstetric admissions into the Intensive Care Unit in a Sub-urban university teaching hospital. Niger J Obestet Gynaecol 2011;6:33-6.
Idris SH, Sambo MN, Ibrahim MS. Barriers to utilisation of maternal health services in a semi-urban community in Northern Nigeria: The clients' perspective. Niger Med J 2013;54:27-32.
Adeoye IA, Onayade AA, Fatusi AO. Incidence, determinants and perinatal outcomes of near miss maternal morbidity in Ile-Ife Nigeria: A prospective case control study. BMC Pregnancy Childbirth 2013;13:93.
Togal T, Yucel N, Gedik E, Gulhas N, Toprak HI, Ersoy MO, et al. Obstetric admissions to the Intensive Care Unit in a tertiary referral hospital. J Crit Care 2010;25:628-33.
Ebirim LN, Ojum S. Admissions of obstetric patients in the Intensive Care Unit: A 5 year review. J Med Med Sci 2012;3:741-4.
Okafor UV, Aniebue U. Admission pattern and outcome in critical care obstetric patients. Int J Obstet Anesth 2004;13:164-6.
Ramachandra Bhat PB, Navada MH, Rao SV, Nagarathna G. Evaluation of obstetric admissions to Intensive Care Unit of a tertiary referral center in coastal India. Indian J Crit Care Med 2013;17:34-7.
Okafor UV. Challenges in critical care services in sub-Saharan Africa: Perspectives from Nigeria. Indian J Crit Care Med 2009;13:25-7.
Ghike S, Asegaonkar P. Why obstetrics patients are admitted into Intensive Care Units? A retrospective study. J S Asian Fed Obstet Gynaecol 2012;4:90-2.
El-Sawaf A, Shehata M. Acute severe obstetric events in critical care medicine department, Cairo university: Nature and outcome. Med J Cairo Univ 2012;80:665-71.
Sultan P, Arulkumaran N, Rhodes A. Provision of critical care services for the obstetric population. Best Pract Res Clin Obstet Gynaecol 2013;27:803-9.
Eyelade OR, Amanor-Boadu SD, Sanusi AA, Olumole OA, Sotunbi PT, Soyanwo OA, et al. Intensive Care Unit admission during the puerperium in Ibadan. Trop J Obstet Gynaecol 2005;22:56-9.
Muhammed Z, Muhammed D, Ibrahim SA. Obstetric admission to the Intensive Care Unit: A seven years review at the Aminu Kano teaching hospital Kano, Nigeria. Borno Med J 2010;7:1-15.
Ezegwui H, Onoh R, Ikeako L, Onyebuchi A, Umeora O, Ezeonu P, et al. Investigating maternal mortality in a public teaching hospital, Abakaliki, Ebonyi State, Nigeria. Ann Med Health Sci Res 2013;3:75-80.
Selo-Ojeme DO, Omosaiye M, Battacharjee P, Kadir RA. Risk factors for obstetric admissions to the Intensive Care Unit in a tertiary hospital: A case-control study. Arch Gynecol Obstet 2005;272:207-10.
Okafor UV, Efetie ER, Amucheazi A. Risk factors for maternal deaths in unplanned obstetric admissions to the Intensive Care Unit-lessons for sub-Saharan Africa. Afr J Reprod Health 2011;15:51-4.
Umeora OU, Ejikeme BN, Egwuatu VE. Contribution of ruptured uterus to maternal mortality in rural South Eastern Nigeria. Trop J Obstet Gynaecol 2005;22:184-8.