Publication:

A cross-sectional study on referred obstretric patients to a tertiary care centre

Background Most of the obstetric patients can be managed at primary health center. Identifying high risk obstetric cases, severe maternal complications and timely referring them to a centre equipped with basic emergency obstetric and newborn care helps to reduce feto-maternal mortality and morbidity. This study was aimed to study the clinical profile of referred obstetric patients to SSIMS & RC and made to assess the feto- maternal outcome.

Methods A prospective observational study was conducted from June 2023 to May 2024 in the department of Obstetrics and Gynecology at SS institute of medical sciences and Research Centre, Davanagere. The study included all women referred while pregnant (irrespective of gestational age) during labor and within immediate postpartum (1 week following delivery). Sociodemographic profile, cause for referral and maternal and perinatal outcome was studied.

Results In the present study 276 obstetrics patients were included. The main causes for referral were previous LSCS 76 (27.5%), pre-eclampsia 20 (7.24%), Rh negative pregnancy 20 (7.24%), preterm labor 16 (5.79%) and postpartum referral 4 (1.44%). Among them 228 (91.9%) underwent emergency LSCS and 20 (8.06%) delivered vaginally. Main maternal complications observed were acute renal failure 8 (40%), wound sepsis 4 (20%), peripartum cardiomyopathy 2 (10%), postpartum psychosis 2(10%). Out of 248 deliveries;158 babies were healthy (63.7%) and 90 (36.2%) babies had NICU admission.

Conclusions Ours being a tertiary care hospital, wide spectrum of complicated obstetric cases is referred to us. Referral system is an important part of health care system. Identification of high-risk women and timely referral to an equipped center will help in reducing feta-maternal morbidity and mortality.