Assessment of clinical characteristics and outcomes of obstetric patients admitted to the intensive care unit at two selected public hospitals: A retrospective study.
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Date
2025
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Addis Ababa Uinverstiy
Abstract
Background: Obstetric complications remain a leading cause of maternal morbidity and mortality globally, particularly in low-resource settings such as Ethiopia. Despite improvements in antenatal care and delivery services, severe obstetric complications requiring intensive care unit (ICU) admission continue to pose major challenges, causing feto-maternal morbidity and mortality.
Objective: To assess the prevalence, clinical profiles, and outcomes of obstetric complications among ICU admissions and identify factors associated with maternal mortality in ICU settings.
Methods: A retrospective cross-sectional study was conducted on all obstetric patients admitted to the ICUs of ALERT and Zewditu Memorial Hospitals from July 1, 2023, to July 1, 2025. Data were extracted from medical records using a structured questionnaire. Descriptive statistics summarized patient demographics, obstetric complications, and clinical profile. Bivariable and multivariable logistic regression analyses were applied to identify predictors of ICU mortality. Statistical significance was set at p<0.05.
Results: Of the 101 obstetric ICU admissions analyzed, the predominant diagnoses were eclampsia (31.7%), postpartum hemorrhage (29.7%), and preeclampsia (27.7%). System specific medical emergencies such as respiratory, renal, infectious, hematologic and neurologic system were observed in two-thirds of patients. The overall in ICU mortality rate was 21.8% (95% CI: 14%-30%). Place of residence emerged as the only significant predictor of ICU
mortality, with women residing outside Addis Ababa exhibiting higher odds of death compared to those from in the city (AOR: 6.17; 95%CI: 1.24–30.73).
Conclusion: Eclampsia, post-partum hemorrhage and pre-eclampsia were the leading causes of ICU admission. strengthening early identification and timely intervention at primary and secondary health care facilities could help reduce the need for ICU admission. Place of residence was the only significant factor associated with in ICU mortality. It is recommended that strengthening referral and transportation systems for obstetric emergencies might help
reduce morbidity and mortality.
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Keywords
: Obstetric complications, Intensive Care Unit, Maternal mortality, Ethiopia