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Brief Communications
[4] Vohr BR, Poindexter BB, Dusick AM, McKinley LT, Higgins RD, Langer JC, et al. Persistent beneficial effects of breast milk ingested in the neonatal intensive care unit on outcomes of extremely low birth weight infants at 30 months of age. Pediatrics 2007;120(4):e953–9.
[5] Kennaugh J, Lockhart-Borman L. The increasing importance of human milk banks. e-J Neonatol Res 2011;1(3):119–25.
http://dx.doi.org/10.1016/j.ijgo.2014.10.015 0020-7292/© 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Obstetric and gynecologic admissions to the intensive care unit at Khartoum Hospital, Sudan Ibrahim A. Ibrahim a, Duria A. Rayis a,⁎, Mohamed A. Alsammani b,c, Ishag Adam a,b a b c
Department of Obstetrics and Gynecology, Faculty of Medicine, University of Khartoum, Khartoum, Sudan Department of Obstetrics and Gynecology, Qassim College of Medicine, Qassim University, Gassim, Saudi Arabia Department of Obstetrics and Gynecology, Faculty of Medicine, Bahri University, Khartoum, Sudan
a r t i c l e
i n f o
Article history: Received 1 September 2014 Received in revised form 2 October 2014 Accepted 4 December 2014 Keywords: Case fatality Intensive care unit Maternal mortality Sudan
Indications for admission to the intensive care unit (ICU) are numerous, and high mortality rates among such patients are found in lowresource countries [1–3]. Few published data exist on ICU admission in African countries, including Sudan. The aim of the present study was to investigate the causes of admission to the ICU among obstetric and gynecologic patients and their outcomes from January 1 to December 31, 2012, at Khartoum Hospital, Sudan. The study received ethical approval from the Research and Ethics Committee of Khartoum University. Data on indications for admission, associated medical conditions, complications, duration of ICU stay, and maternal and fetal outcomes were collected using questionnaires that were completed by a trained medical officer. A total of 99 ob/gyn patients were admitted to the ICU over the study period: 67 (67.7%) obstetric and 32 (32.3%) gynecologic. Of 5400 deliveries over the study period, this represents an admission rate of 1.8%. This is higher than the rate of 0.22% for obstetric admissions to an ICU observed in Saudi Arabia [2]. The most common reasons for ICU admission among the 67 obstetric cases were eclampsia (n = 30, 44.8%), postpartum hemorrhage (n = 21,
31.3%), jaundice (n = 7, 10.4%), cardiac diseases (n = 7, 10.4%), and more than one diagnosis (n = 2, 3%). Among the 32 gynecologic patients, the most common reasons for admission were infections (n = 19, 59.3%), ovarian and cervical cancer (n = 6, 18.7%), anesthetic complications (n = 3, 9.4%), and multiple organ dysfunction (n = 4, 12.5%). The mean duration of stay for ob/gyn patients in the ICU was 3.8 ± 1.4 days. Previous studies have also reported that hemorrhage and hypertension were the main obstetric reasons for admission to the ICU [1,2]. There were 22 (22.2%) deaths among the 99 ob/gyn patients: 15 (22.4%) obstetric and 7 (21.9%) gynecologic. The maternal mortality rate was 9.4% among obstetric patients admitted to an ICU in Saudi Arabia [2]. In general, the mortality rate among patients admitted to an IUC in low-resource countries is high [3]. The underlying cause of death was jaundice in 6 (27.3%) patients, eclampsia in 5 (22.7%), sepsis in 4 (18.2%), malignancies in 5 (22.7%), pulmonary embolism in 1 (4.5%), and postpartum hemorrhage in 1 (4.5%) patient. Of the 67 obstetric cases, there were 8 (11.9%) stillbirths and 22 (32.8%) early neonatal deaths. There is high maternal mortality in Sudan owing to hemorrhage, hypertension, septicemia, and malaria [4]. The shortcomings of the study are its hospital-based nature. In addition, individual risk factors and some essential variables were not examined, for example prenatal care. Conflict of interest The authors have no conflicts of interest. References [1] Naylor Jr DF, Olson MM. Critical care obstetrics and gynecology. Crit Care Clin 2003; 19(1):127–49. [2] Al-Suleiman SA, Qutub HO, Rahman J, Rahman MS. Obstetric admissions to the intensive care unit: a 12-year review. Arch Gynecol Obstet 2006;274(1):4–8. [3] Kwizera A, Dünser M, Nakibuuka J. National intensive care unit bed capacity and ICU patient characteristics in a low income country. BMC Res Notes 2012;5:475. [4] Elhassan EM, Mirghani OA, Adam I. High maternal mortality and stillbirth in the Wad Medani Hospital, Central Sudan, 2003–2007. Trop Doct 2009;39(4):238–9.
⁎ Corresponding author at: Faculty of Medicine, University of Khartoum, P.O. Box 102, Khartoum, Sudan. Tel.: +249 912305017; fax: +249 183771211. E-mail address: [email protected] (D.A. Rayis).
http://dx.doi.org/10.1016/j.ijgo.2014.10.019 0020-7292/© 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Brief Communications
[4] Vohr BR, Poindexter BB, Dusick AM, McKinley LT, Higgins RD, Langer JC, et al. Persistent beneficial effects of breast milk ingested in the neonatal intensive care unit on outcomes of extremely low birth weight infants at 30 months of age. Pediatrics 2007;120(4):e953–9.
[5] Kennaugh J, Lockhart-Borman L. The increasing importance of human milk banks. e-J Neonatol Res 2011;1(3):119–25.
http://dx.doi.org/10.1016/j.ijgo.2014.10.015 0020-7292/© 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Obstetric and gynecologic admissions to the intensive care unit at Khartoum Hospital, Sudan Ibrahim A. Ibrahim a, Duria A. Rayis a,⁎, Mohamed A. Alsammani b,c, Ishag Adam a,b a b c
Department of Obstetrics and Gynecology, Faculty of Medicine, University of Khartoum, Khartoum, Sudan Department of Obstetrics and Gynecology, Qassim College of Medicine, Qassim University, Gassim, Saudi Arabia Department of Obstetrics and Gynecology, Faculty of Medicine, Bahri University, Khartoum, Sudan
a r t i c l e
i n f o
Article history: Received 1 September 2014 Received in revised form 2 October 2014 Accepted 4 December 2014 Keywords: Case fatality Intensive care unit Maternal mortality Sudan
Indications for admission to the intensive care unit (ICU) are numerous, and high mortality rates among such patients are found in lowresource countries [1–3]. Few published data exist on ICU admission in African countries, including Sudan. The aim of the present study was to investigate the causes of admission to the ICU among obstetric and gynecologic patients and their outcomes from January 1 to December 31, 2012, at Khartoum Hospital, Sudan. The study received ethical approval from the Research and Ethics Committee of Khartoum University. Data on indications for admission, associated medical conditions, complications, duration of ICU stay, and maternal and fetal outcomes were collected using questionnaires that were completed by a trained medical officer. A total of 99 ob/gyn patients were admitted to the ICU over the study period: 67 (67.7%) obstetric and 32 (32.3%) gynecologic. Of 5400 deliveries over the study period, this represents an admission rate of 1.8%. This is higher than the rate of 0.22% for obstetric admissions to an ICU observed in Saudi Arabia [2]. The most common reasons for ICU admission among the 67 obstetric cases were eclampsia (n = 30, 44.8%), postpartum hemorrhage (n = 21,
31.3%), jaundice (n = 7, 10.4%), cardiac diseases (n = 7, 10.4%), and more than one diagnosis (n = 2, 3%). Among the 32 gynecologic patients, the most common reasons for admission were infections (n = 19, 59.3%), ovarian and cervical cancer (n = 6, 18.7%), anesthetic complications (n = 3, 9.4%), and multiple organ dysfunction (n = 4, 12.5%). The mean duration of stay for ob/gyn patients in the ICU was 3.8 ± 1.4 days. Previous studies have also reported that hemorrhage and hypertension were the main obstetric reasons for admission to the ICU [1,2]. There were 22 (22.2%) deaths among the 99 ob/gyn patients: 15 (22.4%) obstetric and 7 (21.9%) gynecologic. The maternal mortality rate was 9.4% among obstetric patients admitted to an ICU in Saudi Arabia [2]. In general, the mortality rate among patients admitted to an IUC in low-resource countries is high [3]. The underlying cause of death was jaundice in 6 (27.3%) patients, eclampsia in 5 (22.7%), sepsis in 4 (18.2%), malignancies in 5 (22.7%), pulmonary embolism in 1 (4.5%), and postpartum hemorrhage in 1 (4.5%) patient. Of the 67 obstetric cases, there were 8 (11.9%) stillbirths and 22 (32.8%) early neonatal deaths. There is high maternal mortality in Sudan owing to hemorrhage, hypertension, septicemia, and malaria [4]. The shortcomings of the study are its hospital-based nature. In addition, individual risk factors and some essential variables were not examined, for example prenatal care. Conflict of interest The authors have no conflicts of interest. References [1] Naylor Jr DF, Olson MM. Critical care obstetrics and gynecology. Crit Care Clin 2003; 19(1):127–49. [2] Al-Suleiman SA, Qutub HO, Rahman J, Rahman MS. Obstetric admissions to the intensive care unit: a 12-year review. Arch Gynecol Obstet 2006;274(1):4–8. [3] Kwizera A, Dünser M, Nakibuuka J. National intensive care unit bed capacity and ICU patient characteristics in a low income country. BMC Res Notes 2012;5:475. [4] Elhassan EM, Mirghani OA, Adam I. High maternal mortality and stillbirth in the Wad Medani Hospital, Central Sudan, 2003–2007. Trop Doct 2009;39(4):238–9.
⁎ Corresponding author at: Faculty of Medicine, University of Khartoum, P.O. Box 102, Khartoum, Sudan. Tel.: +249 912305017; fax: +249 183771211. E-mail address: [email protected] (D.A. Rayis).
http://dx.doi.org/10.1016/j.ijgo.2014.10.019 0020-7292/© 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
