A Five-year Review of the Pattern and Outcome of Obstetric Admissions into the Intensive care unit of a University Teaching Hospital in Southern Nigeria

Background: The care of critically ill patients remains a herculean task in developing countries, Nigeria inclusive. This is due to the late presentation of patients, and the need for highly specialized equipment and professionals.
Objectives: To determine the incidence, pattern and maternal outcome of obstetric patients admitted to the intensive care unit (ICU) of the University of Port Harcourt Teaching Hospital.
Material and Methods: A five-year retrospective study of 141 obstetric admissions to the ICU from January 1, 2012 to December 31, 2016. A pre-structured questionnaire was used to obtain information from the case files, theatre, and ICU registers. Data obtained was collated, entered in a spread sheet, and analyzed using SPSS version 22.0. Results are expressed in means and percentages.
Results: There were 917 ICU admissions during the period under review. Of these, 141 were obstetric patients, constituting 15.4% of the total ICU admissions. The mean age was 31.73 ± 5.9 years, and the mean parity was 1.6 ± 1.5. About two-thirds 82 (69.5%) of the women were unbooked. Obstetric haemorrhage was the most common indication for admission, 50 (42.3%), followed by severe pre-eclampsia/eclampsia 32 (27.2%). Majority (42.4%) of the patients had caesarean sections, while 18.6% had abdominal hysterectomy. The average length of stay was 3.4 days. The maternal mortality rate was 31.36%.
Conclusion: Admissions into the ICU was more common among unbooked obstetric patients. Obstetric haemorrhage remains a major cause of maternal deaths in developing countries, and the most common indication for ICU admissions.