Clinical Study

Critical care obstetrics in a developing country

  • Ugochukwu Vincent Okafor
  • Efenae Russ Efetie

Received Date: 20.06.2007 Accepted Date: 13.09.2007 J Turk Ger Gynecol Assoc 2008;9(1):9-13

OBJECTIVE:

A retrospective review of the pattern of obstetric admissions to the general intensive care unit of National Hospital, Abuja, Nigeria over a 5 year (March 2000 to February 2005) span was carried out.

METHODS:

The patients’ case files and intensive care unit records of 54 patients were used to extract the relevant data.

RESULTS:

The records of 54 obstetric patients admitted to the intensive care unit during the study period were reviewed with 6063 live births giving an ICU admission rate of 9.7/1000 live births in the hospital. The average age of the patients was 29.84 years (range 17-40). Forty-four (81.5%) of the patients had eclampsia, five patients (9.3%) had severe pre-eclampsia. Two patients (5.55%) had obstetric hemorrhage while the remaining were admitted for the following reasons; postpartum cerebrovascular accident (one patient or 1.8%), severe postoperative respiratory distress (one patient or 1.8%) and septicemia (one patient or 1.8%). Twenty of the patients (37%) received mechanical ventilation with the Newport ventilator while 32 patients (59%) received oxygen therapy through intranasal prongs or cannulae. Two patients (4%) were on room air throughout admission. There were fifteen deaths during the study period, thirteen deaths in the eclampsia group (29.5% mortality in the eclampsia group), one death in the obstetric hemorrhage group (50% mortality in the obstetric hemorrhage group) and a death in the patient with septicemia (100% mortality). All admissions occurred in the postpartum period.

CONCLUSION:

The high maternal mortality in this study highlights the problem of critical care obstetrics in the developing world. However, unlike other studies, eclampsia was the predominant diagnoses at intensive care unit admission. Late presentation of patients coupled with a paucity of intensive care units may have contributed to high maternal mortality in this study.

Keywords: Eclampsia, critical care, intensive care unit