Admission Indications and Outcomes of Obstetric Patients in the Intensive Care Unit (ICU) at the University Teaching Hospital of Kigali (CHUK): A retrospective descriptive study

BACKGROUND: Maternal mortality in Rwanda has decreased dramatically in the last 15 years, but little is known about indications for admission and outcomes of obstetric patients admitted to the intensive care unit (ICU) in Rwanda. The objective of this study was to determine the indications for admission and the outcome of obstetric patients admitted to the ICU at University Teaching Hospital of Kigali (CHUK).
METHODS: We performed a retrospective case-file review of obstetric patients admitted to the ICU at CHUK during the 1-year period of June 2016 to July 2017. The outcomes measured were indications for ICU admission and the ICU case fatality rate.
RESULTS: 72 patients were enrolled, of which 64 (89%) had sufficient data to be included in the study. The median patient age was 28years, the median length of stay was two days, and the overall mortality was 61%. The indications for admission were post-partum hemorrhage-PPH (28%), respiratory failure (20%), preeclampsia/eclampsia/HELLP syndrome (19%), sepsis/septic shock (17%), and other (14%). The case fatality rate was highest for sepsis/septic shock (90%) followed by PPH/hemorrhagic shock (72%), respiratory failure (62%), preeclampsia/eclampsia (33%), cerebral malaria (50%), and heart failure (50%).
CONCLUSION: The results of this study suggest that despite great improvements in maternal care in Rwanda, much work remains to be done in order to improve maternal ICU mortality rates. Further studies are needed to identify ways to improve the management of the common causes of maternal mortality across the referral system in Rwanda.