A study on referred obstetric cases in a tertiary care hospital in central India

Abstract

Introduction: To identify the pattern of obstetric referrals to our tertiary care hospital. To identify the primary reasons for referral, clinical course, mode of management and outcome. Methods: It was a retrospective observational study. All the referred obstetric cases were analyzed for the cause of referral, their condition and outcome for a period of 6 months from Jan 2020 to June 2020. Results: The proportion of referred cases was 32.5%. Maximum number of patients were in 20-30yrs age group comprising 82.9% of cases. Majority of patients were primigravida (55.2%). Hypertensive disorders (26%) and previous caesarean (9.2%) were major causes of referral. 34.4% of patients were from within Indore District and 65.6% from outside Indore District. 43.5% patients had vaginal delivery, 33.6% underwent LSCS, conservative management was done in 14% cases. Maternal deaths were in 2.6% out of total referred cases. Hypertensive disorders and obstetric hemorrhage 26% were major direct causes of mortality. Anemia (12%) being common indirect cause. Conclusion: Health education to the community, better antenatal care up to the grass root level, emergency intranatal care, availability of services of skilled birth attendants at the time of child birth, well organized first referral centre with better transportation facility, availability of blood round the clock, anesthetic facilities and availability of specialist in the field of obstetrics at the referral unit will definitely reduce maternal and perinatal morbidity and mortality.