ArticleBMC pregnancy and childbirth2021
High mortality rate of obstetric critically ill women in Rwanda and its predictability.
Article in BMC pregnancy and childbirth, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Obstetric admission and maternal mortality in the intensive care unit in Africa: A systematic review and meta-analysis.PloS one · 2025Pooled it
- Strategies to improve outcomes of obstetric emergencies in sub-Saharan Africa: A scoping review.PloS one · 2026Article
- Time to maternal death and its predictors among obstetric ICU patients in a resource-limited setting: A 10-year survival analysis.PloS one · 2026Article
- Association between activated partial thromboplastin time and septic shock in pregnant women: a retrospective cohort study.Frontiers in medicine · 2026Article
- Determinants of puerperal sepsis among mothers who give birth at Jigjiga Public Hospitals, Jigjiga, Somali Regional State, Eastern Ethiopia: a facility-based unmatched case-control study.BMC pregnancy and childbirth · 2025Article
- Determinants of maternal mortality among obstetric patients admitted to intensive care unit of Wolaita Sodo comprehensive specialized hospital, Southern Ethiopia: unmatched case-control study.BMC pregnancy and childbirth · 2025Article
- A health systems approach to critical care delivery in low-resource settings: a narrative review.Intensive care medicine · 2023Review
- A ten-year review of indications and outcomes of obstetric admissions to an intensive care unit in a low-resource country.PloS one · 2021Article
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3 authors.
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Abstract
backgroundReasons for admission to intensive care units (ICUs) for obstetric patients vary from one setting to another. Outcomes from ICU and prediction models are not well explored in Rwanda owing to lack of appropriate scores. This study aimed to assess reasons for admission and accuracy of prediction models for mortality of obstetric patients admitted to ICUs of two public tertiary hospitals in Rwanda.
methodsWe prospectively collected data from all obstetric patients admitted to the ICUs of the two public tertiary hospitals in Rwanda from March 2017 to February 2018 to identify reasons for admission, demographic and clinical characteristics, outcome including death and its predictability by both the Modified Early Obstetric Warning Score (MEOWS) and quick Sequential Organ Failure Assessment (qSOFA). We analysed the accuracy of mortality prediction models by MEOWS or qSOFA by using logistic regression adjusting for factors associated with mortality. Area under the Receiver Operating characteristic (AUROC) curves is used to show the predicting capacity for each individual tool.
resultsObstetric patients (n = 94) represented 12.8 % of all 747 ICU admissions which is 1.8 % of all 4.999 admitted women for pregnancy or labor. Sepsis (n = 30; 31.9 %) and obstetric haemorrhage (n = 24; 25.5 %) were the two commonest reasons for ICU admission. Overall ICU mortality for obstetric patients was 54.3 % (n = 51) with average length of stay of 6.6 ± 7.525 days. MEOWS score was an independent predictor of mortality (adjusted (a)OR 1.25; 95 % CI 1.07-1.46) and so was qSOFA score (aOR 2.81; 95 % CI 1.25-6.30) with an adjusted AUROC of 0.773 (95 % CI 0.67-0.88) and 0.764 (95 % CI 0.65-0.87), indicating fair accuracy for ICU mortality prediction in these settings of both MEOWS and qSOFA scores.
conclusionsSepsis and obstetric haemorrhage were the commonest reasons for obstetric admissions to ICU in Rwanda. MEOWS and qSOFA scores could accurately predict ICU mortality of obstetric patients in resource-limited settings, but larger studies are needed before a recommendation for their use in routine practice in similar settings.
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