Obstetric Complications in the General ICU at CHU Gabriel Touré, Bamako Management and Prognostic Factors

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Introduction: Obstetric complications remain a major cause of maternal morbidity and mortality in sub-Saharan Africa, particularly when intensive care is required. This study aimed to analyse the epidemiological, clinical, therapeutic and prognostic aspects of these complications. Methods: We conducted a 12-month descriptive and analytical study (March 2024 to February 2025) in the general intensive care unit (ICU) of CHU Gabriel Touré. All women admitted for obstetric complications were included. Data were entered and analysed using SPSS® 22.0. Results: Of 674 ICU admissions, 244 involved obstetric complications (36.2%). Mean age was 25.7 ± 7.1 years. Most patients were housewives (80%) and primigravidae (34.4%); over three-quarters (76.2%) had no antenatal care. Clinical findings included tachycardia (45%), arterial hypertension (45%), hypotension (35%) and anaemia (65%). The main obstetric complications were eclampsia (43%), retroplacental haematoma (36%), haemorrhagic shock (33.6%) and acute kidney injury (22.9%). Management comprised initial stabilisation (100%), oxygen therapy (39.7%), ventilatory support (50%), and blood transfusion (36.5%), predominantly red cell concentrates (65.1%). Magnesium sulphate (29.5%) and antihypertensives (25%) were used; noradrenaline was the vasopressor of choice (98%). Mean length of stay was 2.8 ± 2.32 days. Mortality was 17.6%. Prognostic analysis showed significant associations between mortality and eclampsia (p=0.000; RR=4.65 [2.04–10.62]), acute kidney injury (p=0.000; RR=3.12 [1.83–5.65]) and haemorrhagic shock (p=0.000; RR=2.75 [1.58–4.79]). Conclusion: Obstetric complications are frequent and carry substantial mortality. Strengthening antenatal care and ensuring timely, protocol-driven management are essential to improve maternal outcomes.

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