article · Tanzania Medical Journal
A study conducted at Muhimbili National Hospital in Tanzania reviewed the clinical profiles and outcomes of critically ill obstetric patients admitted to its intensive care unit between November 2017 and December 2018. Out of 10,112 women who delivered at the hospital during this period, 257 were admitted to the unit, representing 0.25 percent of deliveries. The admitted women had a mean age of 28 years, and most were multiparous and admitted after childbirth. The primary reasons for intensive care admission were pregnancy-related hypertension and its complications, accounting for 45.5 percent of cases, followed by obstetric haemorrhage at 33.1 percent. The primary medical interventions administered included blood transfusions, anticonvulsant medications, and mechanical ventilation. The overall maternal fatality rate within the intensive care unit was 20 percent.
Understanding the primary complications leading to critical illness during pregnancy and the postpartum period helps hospitals allocate vital healthcare resources. By identifying haemorrhage and hypertension as major drivers of intensive care admissions and mortality, healthcare facilities can target clinical training, improve early detection protocols, and strengthen specialized intensive care units to save mothers and neonates.
The abstract does not indicate an application pathway, as it focuses on an observational clinical study of hospital admissions and outcomes.
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Background Critical illness during pregnancy and puerperium may result from -associated complications, non-obstetric medical illness, or preexisting conditions. The best outcome for both maternal and neonates depends on the multidisciplinary approach, from the involvement of obstetricians, neonatologists, physicians or surgeons and critical care physicians. Muhimbili national hospital’s obstetric critical care unit is still in the early stage, therefore there is a need to study the clinical profiles and treatment outcomes of critically ill obstetric patients for further improvement of maternal health care. Methods A cross-sectional facility-based study was conducted using 257 case files of women who were admitted to the obstetric intensive care unit during pregnancy or puerperium from November 2017 to December 2018 at Muhimbili National Hospital. The socio-demographic characteristics, indications for admission, interventions given, and maternal and fetal outcomes were retrieved from the case files and charts using a checklist. Statistical software version 23 was used and the descriptive statistics were presented in frequency and summarized in tables. Results Over a fourteen-month study period, 10,112 women were delivered at Muhimbili National Hospital, and 0.25% were admitted to the Obstetric intensive care unit with a mean age of 28±6.6 SD. Most patients were multiparous and admitted during the postpartum period. Obstetric hemorrhage (33.1%) and pregnancy-related hypertension with its complications (45.5%) were the leading causes of admissions. The most common interventions done were blood transfusion (53.3%), anticonvulsants (31.1%) and mechanical ventilation (28.8%). Overall, the fatality rate among women admitted to Intensive care unit was 20%. Conclusion Critically ill obstetric patients were relatively young in our study population, mostly admitted due to obstetric hemorrhage and pregnancy-related hypertension. Morbidity and Mortality associated with these conditions are preventable by emphasizing on early detection and involvement of a multidisciplinary team with increased access to a dedicated intensive care unit and high dependency unit.
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DOI: 10.4314/2ctw8k11
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