International Journal of Research in Medical Sciences | May 2019 | Vol 7 | Issue 5 Page 1420
International Journal of Research in Medical Sciences
Onyekwulu FA et al. Int J Res Med Sci. 2019 May;7(5):1420-1424
www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012
Original Research Article
Trends of critical care management of obstetric patients in a tertiary
hospital in sub-Saharan Africa
Fidelis A. Onyekwulu
1
*, Tochukwu C. Okeke
2
INTRODUCTION
Maternal morbidity and mortality are a topical issue
world over and management of critically ill obstetric
patients is very challenging to the critical care specialist
as well as the obstetricians. The maternal mortality rate in
sub-Saharan Africa in high compared to other regions of
the world. The lifetime risk of dying during pregnancy is
1 in 16 in sub-Saharan Africa, as compared with 1 in
2800 in developed regions.
1
After two decades of the
Safe Motherhood Initiative, meaningful reductions in
maternal mortality and disability during pregnancy and
childbirth in developing countries have not been
realized.
2
This could be attributed to the level of poverty,
lack of well equipped facility where adequate health care
can be easily accessible. Also, the populace is not well
informed on what to do about their health situations.
Prevention of pregnancy related complications is the key
to reducing maternal mortality and morbidity. Early
presentation to a health facility and referral is paramount.
When this is not the case, late presentation to a tertiary
1
Department of Anaesthesia, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu, Nigeria
2
Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu, Nigeria
Received: 30 January 2019
Accepted: 09 March 2019
*Correspondence:
Dr. Fidelis A. Onyekwulu,
E-mail: faonyekwulu@yahoo.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Background: The maternal mortality rate in sub-Saharan Africa is high compared to other regions of the world.
Management of critically ill obstetric patients is very challenging. We therefore evaluate the trends, clinical
characteristics and outcome of the obstetric patients admitted into the intensive care unit of a tertiary hospital in sub
Saharan Africa.
Methods: This was a 9- year retrospective study carried out at the multidisciplinary Intensive Care Unit (ICU) of a
University Teaching Hospital which serves as a referral centre for the south east region of the country. Data were
collected from the patients’ record, ICU admission and discharge register. Also collected was data concerning labor
ward admission and deliveries. Data was analyzed using SPSS Version 17 (SPSS Inc., Chicago, IL, USA).
Results: The total admission into the ICU during the study period was 1243 patients of which 73 (5.87%) were
obstetric patients. They were between the ages of 17 and 54 years with mean of 32.05±5.96 years. The total number
of deliveries within the period was 11224 (1247 per year). The commonest obstetric cases admitted into the ICU were
(pre) eclampsia 28.8% followed by obstetric hemorrhage 24.7%. The overall mortality rate in this study was 39.7%.
The commonest intervention carried out in the ICU was mechanical ventilation.
Conclusions: The two leading indications for ICU admission and maternal mortality are (pre)eclampsia and obstetric
hemorrhage.
Keywords: Critical care, Intervention, Obstetric patients, Outcome
DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20191627