Abstract:

Introduction: A critically ill obstetric patient represents a challenge that usually requires a multidisciplinary approach. The ICU admission rate in developed countries has been shown to range from 0.1–1.7% and higher in developing countries. Hence, understanding these complications can help in preventing these outcomes and optimize care by assessing the severity and prognosis using a SOFA scoring system.

Methodology: This was a prospective cohort study involving 134 obstetric patients admitted to the critical care unit (CCU) at BMC from June 2023 to February 2024. SOFA scoring system and Criteria for CCU admission were used to identify those who are critically ill. Data were analyzed using STATA v20. Predictors were statistically significant if a p-value 0.05 in bivalent analysis is subjected to multivariate logistic regression.

Results: The mean age was 28.1 ± 7 years. Preeclampsia/eclampsia (56.31%) was the most common obstetric indication of admission followed by obstetric haemorrhage (36.89%). Nonobstetric causes for CCU admission included sickle cell disease, haematological malignancy and anaesthesia complications. Blood transfusion was required in 62.7%, mechanical ventilator was applied in 30.6% followed by an oxygen face mask in 20.1% and dialysis was needed in 19.4%. The mean SOFA score was 5 ± 4 points. Every increase in SOFA score (AOR=1.5;95%CI;1.2-1.8: p-value=0.000) were associated with maternal mortality. The higher the SOFA score the worse the outcome.

Conclusion: SOFA score is associated with maternal death: this score can be used in our setting. Early identification of the need for Critical Care Unit (CCU) care, sufficient pre-ICU resuscitation and supportive care, and timely referral of critical patients will help to improve the outcome of these patients.