European Journal of Molecular & Clinical Medicine

Abstract

Background: Maternal mortality remains a major challenge to health systems worldwide. Women in developing countries often face serious health risks during pregnancy and delivery due to poor access to early and appropriate referrals. Especially in developing country like India, major population lives in rural areas lacking access to essential obstetric facilities. In such areas timely referral of obstetric cases can reduce maternal morbidity and avoid maternal deaths. The referral system is an essential component of any health systems which is particularly important in pregnancy and childbirth for providing access to essential obstetric care. Hence the study was conducted to review the reasons for referral of obstetric cases referred to department of Obstetrics and Gynaecology at tertiary care centre.
Methods: A cross sectional study was carried out in department of Obstetrics and Gynaecology at tertiary care centre during the study period from Jan 2019 to Jan 2020 on all 1067 referred obstetric cases to the hospital. Detailed history of the patients who had been referred from different centres was taken, taking note of the referring centre and reason for referral. Thus all data was collected and compiled in Microsoft excel. Appropriate test was applied for analysis under SPSS software version 21 and P value <0.05 was taken significant.
Results: Majority of cases belonged to age group 20-24 years (52.57%) and 80.3% cases were from rural area. Reasons for referrals among total cases of 906 were Precclampsia 218 (20.43%), ecclampsia 60 (5.62%), previous LSCS 158 (14.81%), Preterm labour 106 (9.93%), PROM 70 (6.56%), Postdated 39 (3.66%), oligohydromnias 33 (3.09%), Breech 23 (2.16%), PPH 22 (2.06%), APH 19 (1.78%), CPD 19 (1.78%), Twins 19 (1.78%), GDM 17 (1.59%), IUGR 12 (1.12%), Placenta previa 12 (1.12%), Rh negative 9 (0.84%), IUD 11 (1.03%), Others 220 (20.62%) respectively.
Conclusion: The present study has shown that peripheral health care system needs to be strengthened and practice of early referral needs to be implemented for better maternal and perinatal outcome. Health education to the community, high risk pregnancy identification and proper antenatal, intra-natal and postnatal care will reduce the incidence of obstetrical referrals.