Obstetric intensive care admissions at a tertiary hospital in Limpopo Province, South Africa

Abstract

OBJECTIVE. To determine the characteristics of obstetric patients admitted to the intensive care unit (ICU) at a tertiary hospital in the Limpopo Province, South Africa. METHODS. Hospital files of all obstetric patients admitted to the Pietersburg provincial referral hospital ICU from 1 January 2008 to 31 December 2012 were retrospectively reviewed. Age, parity, admission diagnosis, length of stay, information on the referring hospitals, and maternal outcomes were analysed. RESULTS. There were 138 obstetric ICU admissions during the study period (6.7% of all ICU admissions and 0.95% of all deliveries). The most common reasons for obstetric ICU admissions were pre-eclampsia or eclampsia (52.9%, n=73/138) and obstetric haemorrhage (18.1%, n=25/138). The mean age of the patients was 28 years, and mean duration of ICU stay was 8 days (range 0 - 163 days). Forty-eight maternal deaths occurred (34.8%), and of these, 27 were referrals from other hospitals (district and regional hospitals). Pre-eclampsia or eclampsia accounted for 25 (52%) of all deaths. CONCLUSION. Obstetric patients formed a small proportion of ICU admissions, but mortality among these patients was high. It is recommended that obstetric registrars rotate through a multidisciplinary ICU, and the need for a critical care specialist should be considered.