Fetomaternal Outcome in Referral Obstetric Patients in Tertiary Care Hospital

Abstract

Aim and objective: To identify indication and fetomaternal outcome of emergency obstetric referral to our hospital so as to reduce fetomaternal morbidity and mortality. Materials and methods: This retrospective observational study was done at the Department of Obstetrics and Gynecology, LTMMC and LTMGH, Sion, Mumbai, for a duration of 1 year from January 2020 to December 2020. All referred patients in emergency for obstetrics indications above 20 weeks were analyzed for fetomaternal outcome and their indication of referral. Results: In our study, of a total of 7,751 delivered patients, 2,233 (28.8%) cases were referred. Maximum 1,711 (76.6%) cases were in the 21–30 years age-group and (66.86%) cases referred from secondary centers. The most common referral indication was fetal, meconium-stained amniotic fluid, and fetal distress 432 (19.4%), followed by preterm labor 291 (11.1%) as maternal indication. One thousand seven hundred twenty-seven (77.4%) patients delivered by lower segment cesarean section. Maternal morbidity was seen in 370 (16.6%) patients, of which 41 (11%) patients required intensive care unit admission. Maternal mortalities were 12. Total 1,832 (80.8%) neonates were shifted to mother and 325 (14.3%) required NICU admission. Conclusion: To reduce unnecessary referrals and burden on tertiary care hospitals, first referral units (FRUs) should be strengthened and healthcare workers should be trained in essential and emergency obstetric care, which will help in reducing morbidity and mortality.