Maternal Referral at Kalabahi General Hospital : A Descriptive Study

Abstract

Objective: To identify the characteristics of maternal referral to the Obstetrics Emergency Unit of Kalabahi General Hospital, Alor Regency, East Nusa Tenggara, Indonesia during the period of January 1, 2016 to December 31, 2017. Methods: This descriptive study was conducted to identify the characteristics of maternal referrals. Sampling method used in this study is a total sampling, in which data from register books and medical records of patients referred to Obstetrics Emergency Unit Kalabahi General Hospital from January 2016 to December 2017 were reviewed. Results: There were 724 referrals to the Obstetric Emergency Unit of Kalabahi General Hospital during the period of 2016-2017, comprising 704 obstetrics cases (97.24%) and 20 gynecology cases (2.76%). Pregnancy risk assessment of these referral cases using Poedji Rochjati Score showed that 353 out of the total 565 cases (62.48%) were high risk pregnancy, and the most frequent cases are severe preeclampsia and eclampsia (46 cases/13.03%), term pregnancy with previous caesarean section (40 cases/11.33%), and breech position 39 cases (11.05%). There are 8 maternal mortality cases caused by delayed referral consisting 5 eclampsia cases and 3 antepartum bleeding cases. Analysis using cross tabulation shows that 97.20% of cases in which the women are aged above 35 were high risk pregnancies. Other cross tabulation shows that 91.55% of grand multiparity cases were high risk pregnancies. There were 452 cases of referral done when the women was in labor, in which 230 cases (50.88%) managed with a caesarean section. Out of those cases, 319 babies (68.02%) were born without asphyxia. Conclusions: Most of the referral in Obstetric Emergency Unit in Kalabahi General Hospital are labor of high risk pregnancies, where in the most of the cases, the risk factors are either the age of the mother or the parities, which is supported by the finding of maternal mortality case.