Outcomes and Associated Factors of Mothers Admitted to Intensive Care Unit During Pregnancy and Postpartum at Saint Paul’s Hospital Millennium Medical College, Ethiopia

Abstract

<p><strong>Background: </strong>Despite the drastic decrease in maternal morbidity over the last few decades, because of improvements in obstetric care, maternal mortality remains to be a challenge in developing world. Analyzing intensive care unit (ICU) utilization during pregnancy and postpartum is an accepted approach to identifying severe and “near-miss” maternal morbidity. Even though data regarding obstetric admission to ICU is available in developed countries, such data is few or lacking in developing countries specially Ethiopia. The objective of the study is to describe profiles and outcomes of women who required admission to intensive care unit (ICU) during pregnancy and Postpartum.</p> <p><strong>Methods: </strong>In this cross-sectional study, data from case notes of 154 women who were admitted to the Saint Paul’s Hospital Millennium medical College ICU during pregnancy and postpartum from 2016 to 2020 were collected using simple data extraction format. Purposive sampling technique was used to include all the mothers admitted over the 5-year period.</p> <p>SPSS version 26 was used for data entry and analysis. Quantitative data is presented as mean ± SD and categorical variables as number (percentage). The association between maternal ICU outcome and associated factors was assessed using Bivariate and Multivariate Logistic regression and P-values less than 0.05 were considered statistically significant.</p> <p><strong>Results: </strong>There were 154 obstetric ICU admissions during the study period. The most common reasons for obstetric ICU admissions were Hypertensive Disorders of Pregnancy (48.7%, n=75/154) and Obstetric Hemorrhage (12.9%, n=20/154). The mean age of the patients was 27.8 years, and median duration of ICU stay was 7 days (range 1-40 days). Forty-six maternal deaths occurred (29.9%) and Hypertensive disorders of pregnancy accounted for 45.6% of all deaths. Not having follow up at this hospital [AOR, 5.480, CI (1.890-15.890)] and shorter ICU stay (less than 10 days) [AOR, 0.127, CI (0.028-0.572)] are positively associated with death of mothers admitted to ICU.</p> <p><strong>Conclusion: </strong>Hypertensive disorders of pregnancy were the leading cause of admission to ICU and leading cause of maternal mortality, which can be easily prevented with early diagnosis and timely intervention. Improving the quality of prenatal care to recognize hypertensive disorders during pregnancy, coupled with prompt management, might help to reduce maternal morbidity and mortality.</p>