Obstetric admissions to intensive care units in Nepal_data

Background: Obstetric complications are an important cause of severe maternal morbidity and mortality, particularly in low- and middle-income countries Data describing the characteristics and outcomes of obstetric patients requiring intensive care in Nepal remain limited. This study aimed to describe the clinical profile, management, and outcomes of obstetric admissions to intensive care units (ICUs) in Nepal.
Methods: A retrospective observational study was conducted using data from the Nepal Intensive Care Research Foundation (NICRF) critical care registry. Women aged 15–49 years who were pregnant, postpartum, or admitted with obstetric-related diagnoses between 2019 and 2024 were included. Of 29,241 ICU admissions recorded in the registry, 257 obstetric patients met the inclusion criteria. Data was analyzed using descriptive statistics and univariate logistic regression.
Results: The mean age of patients was 28.6 ± 5.8 years. The majority (76.3%) were admitted postoperatively, primarily following elective (45.5%) or emergency (23.3%) lower segment caesarean sections (LSCS). Hypertensive disorders of pregnancy accounted for 16% of ICU admissions. Mechanical ventilation was required in 30% of patients, while cardiovascular support was used in 17.9%. The median ICU length of stay was 1 day (IQR 1–3). Overall ICU mortality was 5.4%. Univariate analysis showed that mechanical ventilation (OR 6.57, p < 0.001) and the need for vasoactive therapy (OR 0.10, p < 0.001) were significantly associated with ICU mortality.
Conclusion: Most obstetric ICU admissions in Nepal are postoperative, following caesarean deliveries. Although mortality was relatively low, the need for advanced organ support was strongly associated with poor outcomes. Strengthening early recognition and management of severe obstetric complications may improve maternal outcomes.