Documented Obstetric Haemorrhage in a General Intensive Care Unit in Ghana: Outcomes and the Unadjusted Association Between Recorded GCS and Mortality
7 affiliations
- 1Department of Obstetrics and Gynaecology, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi P.O. Box 1984, Ghana
- 2Department of Obstetrics and Gynaecology, Oak Specialist Hospital, KNUST, Kumasi P.O. Box 420, Ghana
- 3Directorate of Anaesthesia and Intensive Care, Komfo Anokye Teaching Hospital, Adum, Kumasi P.O. Box 1934, Ghana
- 4Department of Anaesthesiology, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi P.O. Box 1984, Ghana
- 5Department of Obstetrics and Gynaecology, Komfo Anokye Teaching Hospital, Adum, Kumasi P.O. Box 1934, Ghana
- 6Department of Obstetrics and Gynaecology, Powerhouse Hospital, Old Tafo, Kumasi P.O. Box SE 1573, Ghana
- 7Department of Obstetrics and Gynaecology, Manhyia Government Hospital, Kumasi P.O. Box 1908, Ghana
Abstract
Background: Obstetric haemorrhage remains an important cause of maternal death and severe morbidity. Outcomes depend on timely recognition, resuscitation, referral, access to blood and essential treatment, and critical care. This study described the clinical characteristics, documented haemorrhage diagnoses, and ICU outcomes of women admitted with obstetric haemorrhage to the main intensive care unit (ICU) of Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana. Methods: This retrospective cohort analysis included 79 women with an obstetric haemorrhage-related diagnosis documented in ICU records, drawn from 344 obstetric ICU admissions between 17 July 2022 and 16 July 2023. Demographic and clinical characteristics, ICU treatments, and outcomes were summarized. Survivors and non-survivors were compared using the Wilcoxon rank-sum test and the chi-square or Fisher exact test, as appropriate. Only unadjusted comparisons are reported because the patient-level dataset required for a prespecified admission-only model was not available for analysis. Results: Among 344 obstetric admissions to KATH’s main ICU, 79 women (23.0%) had documented obstetric haemorrhage and were included. Postpartum haemorrhage was the most common diagnosis (32/79, 40.5%), followed by abruptio placentae (18/79, 22.8%) and uterine rupture (12/79, 15.2%). Forty-four women died in the ICU (55.7%). The GCS variable, labelled “admission GCS” in the source dataset, was lower among non-survivors than survivors (median 8 vs. 15; p < 0.001), as was diastolic blood pressure (71.5 vs. 86 mmHg; p = 0.010). Mechanical ventilation was more frequent among non-survivors (70.5% vs. 40.0%; p = 0.013), while hospital stay was shorter (4 vs. 9 days; p < 0.001). GCS measurement timing could not be verified; treatment and length-of-stay differences describe post-admission care and course. Conclusion: Among women admitted to a general mixed ICU with documented obstetric haemorrhage, ICU mortality was high and postpartum haemorrhage was the most common diagnosis. Lower recorded GCS among non-survivors was an unadjusted descriptive finding; the source dataset’s GCS timing could not be confirmed, and no adjusted prognostic effect can be inferred. Prospective studies with verified admission measures, explicit case criteria, and treatment timing are needed.
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BibTeX
@article{djokoto2026documented,
title = {{Documented Obstetric Haemorrhage in a General Intensive Care Unit in Ghana: Outcomes and the Unadjusted Association Between Recorded GCS and Mortality}},
author = {Rex Mawuli Kwadjo Djokoto and Irene Bandoh and Wilfred Kwamina Junior Sam-Awortwi and Nana Addo Boateng and William Addison and Moses Siaw Frimpong and Edward Anabila Agana and Kingsley Afreh Nduroh and Johnny Arthur-Komeh and Opei Adarkwa and Andrew Panyin Vormawor and Amponsah Peprah and Anthony Amanfo Ofori and Augustine Tawiah},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15218228},
url = {https://www.mdpi.com/2077-0383/15/21/8228},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Documented Obstetric Haemorrhage in a General Intensive Care Unit in Ghana: Outcomes and the Unadjusted Association Between Recorded GCS and Mortality
AU - Rex Mawuli Kwadjo Djokoto
AU - Irene Bandoh
AU - Wilfred Kwamina Junior Sam-Awortwi
AU - Nana Addo Boateng
AU - William Addison
AU - Moses Siaw Frimpong
AU - Edward Anabila Agana
AU - Kingsley Afreh Nduroh
AU - Johnny Arthur-Komeh
AU - Opei Adarkwa
AU - Andrew Panyin Vormawor
AU - Amponsah Peprah
AU - Anthony Amanfo Ofori
AU - Augustine Tawiah
PY - 2026
DA - 2026/10/22
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15218228
UR - https://www.mdpi.com/2077-0383/15/21/8228
AB - Background: Obstetric haemorrhage remains an important cause of maternal death and severe morbidity. Outcomes depend on timely recognition, resuscitation, referral, access to blood and essential treatment, and critical care. This study described the clinical characteristics, documented haemorrhage diagnoses, and ICU outcomes of women admitted with obstetric haemorrhage to the main intensive care unit (ICU) of Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana. Methods: This retrospective cohort analysis included 79 women with an obstetric haemorrhage-related diagnosis documented in ICU records, drawn from 344 obstetric ICU admissions between 17 July 2022 and 16 July 2023. Demographic and clinical characteristics, ICU treatments, and outcomes were summarized. Survivors and non-survivors were compared using the Wilcoxon rank-sum test and the chi-square or Fisher exact test, as appropriate. Only unadjusted comparisons are reported because the patient-level dataset required for a prespecified admission-only model was not available for analysis. Results: Among 344 obstetric admissions to KATH’s main ICU, 79 women (23.0%) had documented obstetric haemorrhage and were included. Postpartum haemorrhage was the most common diagnosis (32/79, 40.5%), followed by abruptio placentae (18/79, 22.8%) and uterine rupture (12/79, 15.2%). Forty-four women died in the ICU (55.7%). The GCS variable, labelled “admission GCS” in the source dataset, was lower among non-survivors than survivors (median 8 vs. 15; p < 0.001), as was diastolic blood pressure (71.5 vs. 86 mmHg; p = 0.010). Mechanical ventilation was more frequent among non-survivors (70.5% vs. 40.0%; p = 0.013), while hospital stay was shorter (4 vs. 9 days; p < 0.001). GCS measurement timing could not be verified; treatment and length-of-stay differences describe post-admission care and course. Conclusion: Among women admitted to a general mixed ICU with documented obstetric haemorrhage, ICU mortality was high and postpartum haemorrhage was the most common diagnosis. Lower recorded GCS among non-survivors was an unadjusted descriptive finding; the source dataset’s GCS timing could not be confirmed, and no adjusted prognostic effect can be inferred. Prospective studies with verified admission measures, explicit case criteria, and treatment timing are needed.
SN - 2077-0383
ER -