Obstetric Admission into the Intensive Care Unit (ICU) of the University of Port Harcourt Teaching Hospital: A Ten-Year Review

Abstract

Background and Aims: This study examines the spectrum of diseases, booking status of women, surgical interventions and maternal outcome of obstetric patients admitted to the intensive care unit (ICU) in the past 10 years. Methodology: A 10-year retrospective review of all obstetric admissions into the ICU from January 2006 to December 2016. The ICU records and case files of the patients were used to extract relevant information. Results: A total of 1548 patients were admitted into the ICU during this period, and 302(19.5%) were obstetric patients. The obstetric patients admitted into the ICU represented 1% of all 31,200 deliveries within the study period. Majority of patients admitted (51.79%) were of the 21-30-year age bracket. Similarly, unbooked patients contributed majority (59%) of admissions. Hypertensive disorders, e.g. Severe pre-eclampsia and Eclampsia constituted the most frequent obstetric diagnosis with a rate of 31.6%. Majority of these patients (65%) had caesarean sections, about 21% had an abdominal hysterectomy and 15% had laparotomy with uterine and bladder repair. The unbooked mothers had a statistically significant incidence of complications which include hypertensive disorders (severe PET, Eclampsia), ruptured uterus compared to the booked obstetric patients. Also, the unbooked mothers were more likely to die than the booked mothers. The maternal mortality was 28.99% of total admissions, amongst which the unbooked mothers accounted for 94% of these deaths and booked mothers 6%. Conclusion: Obstetric patients admitted into the ICU especially the unbooked ones had a high mortality rate and severe morbidity rate in our environment. Therefore, the adoption of the safe motherhood principles remains a key tool in reducing maternal morbidity and mortality, especially in unbooked patients.