Obstetric admissions in a general intensive care unit in north-central Nigeria

Context : Maternal mortality remains unacceptably high in many developing countries and many pregnant women in these countries will require critical care during pregnancy and will be managed in general intensive care units. Objective : To determine the indications for admission of obstetric patients into the general intensive care unit of Jos University Teaching Hospital over a 14 years period and the outcome of their management. Study Design : The study is a retrospective descriptive study. All obstetric admissions into the intensive care unit of Jos University Teaching Hospital from January 1994 to December 2007 were reviewed. Results : There were 231 obstetric admissions which was 17.29% of total ICU admissions and 2.05% of all deliveries in the hospital during the period of review. The mean age of the patients was 25±7.1 years. Pregnancy induced hypertension made up 80.52% of the admissions, while haemorrhage was 12.56% and non-obstetric admission was 6.93%. The most common non-obstetric admission was sepsis (43.70%). Of all admissions 90.91% were in the postpartum period and 9.09% during the antepartum period. The medium length of was two days. The mortality rate was 15.15% with significantly higher ratio of deaths in patients with non-obstetric indications for admission and in patients older than 35 years. Conclusion : There is a high rate of ICU admission of obstetric patients in our hospital. This increases the burden of care in the ICU and contributes to poor outcome. Establishment of obstetric high dependency units will reduce the burden on general ICUs.