Publication:

A study of the causes of referral of obstetric cases in a tertiary care centre and its outcome.

Background This study aims to evaluate the frequency, causes, and outcomes of obstetric referrals at a tertiary care hospital.

Methods An observational study was conducted at Civil Hospital Asarwa, B. J. Medical college Ahmedabad, over six months from December 2021 to May 2022. All referred cases for obstetrics indications were analysed for cause of referral, the facility from which they were referred their condition and outcome. Maternal outcomes in the form of maternal morbidity and mortality were noted.

Results Out of a total of 3010 delivered patients, 229 (9.6%) cases were referred patients. The 87 out of 229 (37.9%) cases were already complicated when received at civil hospital Ahmedabad. Most of the cases 196 (88%) did not receive any treatment at referral hospital before being referred. Only 21.4% patients were referred with referral slips/chit having adequate information. The 183 (18.04%) patients required intensive care unit admission, and 5 maternal deaths were recorded out of those referred (2.1%).

Conclusions The majority of referrals were from rural areas (36%) and medical colleges (18.9%). Such cross referrals should be minimised so as to decrease the burden on tertiary centres. Healthcare workers should be trained in essential and emergency obstetric care which will help in reducing unnecessary referrals, morbidity, and mortality.