“In South Africa, 1 600 women die every year during pregnancy and childbirth, and 10 times more patients suffers severe complications that may lead to brain damage, renal failure and other complications,” says Dr Eduard Langenegger, head of Obstetric Critical Care and Maternal Foetal Medicine at the Department of Obstetrics and Gynaecology of the Faculty of Medicine and Health Sciences. “Death could have been avoided in 20% of these women if there wasn’t a shortage of critical care beds in South Africa.”
The newly-established obstetric critical care unit (OCCU) at Tygerberg Hospital is one of only a few units in the world that specialises in the prevention and treatment of pregnancy complications.
The work done in the unit is aligned with the Millennium Development Goal of reducing maternal mortality, which is one of South Africa’s most pressing health issues.
Pregnancy complications are caused by pre-eclampsia (very high blood pressure), bleeding before, during or after labour, infections and underlying disorders such as heart disease.
The maternal mortality rate of public health care facilities in the Western Cape is the lowest of all provinces in the country and comparable to that of private hospitals. The outcome of very ill mothers and babies treated in the OCCU is as good as, and in some cases even better than, outcomes obtained in countries like the USA, Brazil and the United Kingdom.
The establishment of this emergency care unit in the labour ward of Tygerberg Hospital has already led to a significant decrease in maternal deaths due to pregnancy and non-pregnancy related life-threatening emergencies. Effective emergency management has also decreased long-term complications such as renal failure or cerebral palsy.
“Severe complications increase a patient’s risk of dying by 25%, but if she can get early access to critical care, her risk of dying and complication is reduced,” says Langenegger.
Langenegger and colleagues also developed an OCCU blueprint that can be replicated in other district and tertiary hospitals, and currently are working on creating emergency care beds in Worcester Hospital’s labour ward.
Photo: Drs Langenegger, Moodley and Mr Seconds prepare to transfer a patient that just delivered her baby. She developed pre-eclampsia (very high blood pressure) and then pulmonary oedema (water on the lungs) and had difficulty in breathing. The OCCU team stabilised her and are preparing to transfer her to the OCCU.
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