Department of Anesthesiology, Critical Care and Pain Medicine, School of Medicine, Jimma University, Jimma, Ethiopia.
Department of Anesthesiology, Critical Care and Pain Medicine, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
BMC Womens Health. 2024 Jun 6;24(1):329. doi: 10.1186/s12905-024-03175-z.
Obstetric high-dependency care offers holistic care to critically ill obstetric patients while maintaining the potential for early mother-child bonding. Little is known about the obstetric high-dependency unit (HDU) in Ethiopia. Therefore, the objective of the study was to review the admission indications, initial diagnoses, interventions, and patient outcomes in the obstetric high-dependency unit at St.Paul's Hospital.
A retrospective observational study was carried out at St. Paul's Hospital in Addis Ababa, Ethiopia, between September 2021 and September 2022, targeting patients in the obstetric high-dependency unit during pregnancy or with in 42 days of termination or delivery. A checklist was used to compile sociodemographic and clinical data. Epidata-4.2 for data entry and SPSS-26 for data analysis were employed. Chi-square tests yielded significant results at p < 0.05.
Records of 370 obstetric patients were reviewed and analyzed. The study enlisted participants aged 18 to 40, with a mean age of 27.6 ± 5.9. The obstetric high-dependency unit received 3.5% (95% CI, 3.01-4.30) of all obstetric admissions. With the HDU in place, only 0.42% of obstetric patients necessitated adult intensive care unit (ICU) admission. The predominant motive behind HDU admissions (63.2%) was purely for observation. Hypertensive disorders of pregnancy (48.6%) and obstetric hemorrhage (18.9%) were the two top admission diagnoses. Ten pregnant mothers (2.7%) were admitted to HDU: 2 with antepartum hemorrhages, and 8 with cardiac diseases. Maternal mortality and transfer to the ICU were both 1.4 per 100 HDU patients.
Our study found that the most frequent indication for admission to the HDU was just for observational monitoring. Hypertensive disorders of pregnancy and obstetric hemorrhage were the two leading admission diagnoses. Expanding HDUs nationwide is key for mitigating the ICU burden from obstetric admissions. Strategies for early prenatal screening, predicting preeclampsia, and addressing postpartum hemorrhage should be reinforced. Future studies should focus on a broader array of factors affecting fetomaternal outcomes in such a unit.
产科高依赖病房为重症产科患者提供全面护理，同时保持母婴早期结合的可能性。关于埃塞俄比亚的产科高依赖病房（HDU）知之甚少。因此，本研究的目的是回顾圣保罗医院产科 HDU 的入院指征、初始诊断、干预措施和患者结局。
这是一项在埃塞俄比亚亚的斯亚贝巴圣保罗医院进行的回顾性观察研究，时间为 2021 年 9 月至 2022 年 9 月，目标人群为妊娠期间或分娩后 42 天内入住产科 HDU 的患者。使用检查表来汇编社会人口学和临床数据。采用 Epidata-4.2 进行数据录入，SPSS-26 进行数据分析。卡方检验得出 p<0.05 的显著结果。
共回顾分析了 370 例产科患者的记录。该研究纳入了年龄在 18 至 40 岁之间的参与者，平均年龄为 27.6±5.9 岁。产科 HDU 接收了所有产科入院患者的 3.5%（95%CI，3.01-4.30）。有了 HDU，只有 0.42%的产科患者需要入住成人重症监护病房（ICU）。HDU 入院的主要原因（63.2%）纯粹是为了观察。妊娠高血压疾病（48.6%）和产科出血（18.9%）是两个主要的入院诊断。有 10 位孕妇（2.7%）入住 HDU：2 位有产前出血，8 位有心脏病。产妇死亡率和转入 ICU 率均为每 100 例 HDU 患者 1.4 例。
我们的研究发现，HDU 入院最常见的指征只是为了观察监测。妊娠高血压疾病和产科出血是两个主要的入院诊断。在全国范围内扩大 HDU 是减轻产科入院 ICU 负担的关键。应加强早期产前筛查、预测子痫前期和处理产后出血的策略。未来的研究应侧重于该单位中影响母婴结局的更广泛因素。
