A Review of the Patterns of Admission and Outcome of Postcaesarian Section Patients in the Intensive Care Unit of a Tertiary Hospital in Nigeria

Abstract

Despite the increased utilization of invasive monitoring and mechanical ventilation in the care of the obstetric patient, a dedicated intensive care unit (ICU) for this group of patients is almost lacking in the developing world. Critical care for the obstetric patient has been recognized as a useful tool in the reduction of maternal morbidity and mortality. We sought to review the clinical characteristics and outcome of all post-Caesarean section(C/S) patients admitted into a multi-disciplinary ICU over a 10 year period. Parameters evaluated were indications for C/S, duration of stay, mechanical ventilation and ICU outcome. 114 post-C/S patients were admitted into the ICU during the study period, constituting 9.8% of all admission into the ICU. Emergency C/S constituted 92.2% of all C/Ss and eclampsia represented the commonest indication of C/S requiring care in the ICU. Mortality rate was 23.2% and non post-C/S patients were twice more likely to die in the ICU. Majority of these patients had a short ICU stay, 1-2 days and 19.3% required mechanical ventilation. Obstetric critical care is evolving and increasing proportion of obstetric patients utilized ICU care in our environment. A dedicated ICU for the obstetric patients will afford more of this special group intensive care with improved maternal health.