A study of caesarean sections in referred cases

Authors

  • Devanshi Shah Department of Obstetrics and Gynaecology, SCL Hospital, NHL Municipal Medical College, Gujarat, India
  • Arti Patel Department of Obstetrics and Gynaecology, SCL Hospital, NHL Municipal Medical College, Gujarat, India
  • Maitry Mandaliya Department of Obstetrics and Gynaecology, SCL Hospital, NHL Municipal Medical College, Gujarat, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20215093

Keywords:

Hypertensive disorders of pregnancy, Referral, Community health center, Previous caesarean section

Abstract

Background: Referral is a coordinated movement of healthcare seekers through the health system to reach a high level of care in a small and often fatal window of time. Even physiological processes like pregnancy and childbirth are not free of complications. The purpose of this study is to understand maternal and foetal outcome in caesarean sections in referred cases.

Methods: A prospective study was carried out in the OBGY department of SMT.SCL HOSPITAL, NHL Municipal medical college from April 2020 to April 2021. All referred antenatal and intranatal patients to our tertiary care centre with >20 weeks of gestation who underwent caesarean section with referral note.

Results: A total 64% patients were referred from community health center. 63.5% patients were referred due to lack of high-risk management services. 211 patients underwent caesarean section while 69 patients had normal vaginal delivery. Difficulty in delivery of the baby was encountered in 53% of cases due to deep engagement of the fetal head. Major cause of admission in NICU was sepsis (38.6%) followed by prematurity (23.8%).

Conclusions: Cesarean section is one of the quickest and most efficient method in the delivery of the baby and thus should in considered in patients in critical situations .The millennium development goals defined by united nation includes one goal (MDG 5) towards improving maternal health which still remains a challenge. Thus, improving knowledge of women regarding good antenatal care and strengthening referral services will play a big role in this.

References

Mahendra G, Kavya BS, Pukale R. S.Study of maternal and perinatal outcome in referredobstetric cases. Obs Rev J Obstet Gynecol. 2019;5(2):106-11.

Thaddeus S, Maine D. Too far to walk: maternal mortality in context. Soc Sci Med. 1994;38:1091-110.

Travis P, Bennett S, Haines A, Pang T, Bhutta Z, Hyder AA, et al. Overcoming health systems constraints to achieve the millennium development goals. Lancet. 2004;364:900.

Paxton A, Bailey P, Lobis S. The United Nations process indicators for emergency obstetric care: reflections based on a decade of experience. Int J Gynecol Obstet. 2006;95:192-208.

Morsheda B, Shamsun N, Hashima EN. Assessing the MANOSHI referral system addressing delays in seeking emergency obstetric care in Dhaka’s slums. Available at: https://www.semanticscholar.org/ paper/Assessing-the-MANOSHI-Referral-System-Addressing-in-Banu-Nahar/91fb8ac2f103a52fd35e5 491c1990cfb010eec9c. Accessed on 20 August 2020.

Patel HC, Singh BB, Moitra M, Kantharia SL. Obstetric Referrals: Scenario at a Primary Health Centre in Gujarat. Natl J Community Med. 2012; 3(4):711-4.

Sharma CP, Sharma S, Kumar A, Jain K.A study to assess genuineness of obstetrics/gynaecological patients coming or being referred to medical college hospital in southern district Rajasthan. Natl J Community Med. 2013;4(1):172-4.

Goswami D, Makhija A. A study of high risk obstretic referrals to tertiary care hospital in Garhwal, Uttarakhand. IJSR. 2015;4(10):1091-5

Khatoon A, Hansy SF, Irshad S, Ansari J, An audit of obstetric referrals to Abbasi Shaheed Hospital. Pak J Surg. 2011;27(4): 304-8.

Poornima M, Rekha G Daver. Maternal and fetal outcome in obstetric referred cases. Glob J Res Analys. 2018;7(2):544-7.

Gupta PR, Chaudhary SN, Gonnade NV. Maternal and fetal outcome in referred patients to tertiary care center. Sch J App Med Sci. 2016;4(5C):1624-63.

Charu R, Kamal G, Neelu S. Review of referred obstetric cases–Maternal and Perinatal Outcome. Bombay Hospital J. 2010;52(1):53.

Rao RS, Caleb L, Khan ME, Townsend JW. Safer maternal health in rural Uttar Pradesh: Do primary health services contribute? Health Policy and Planning. 2001:16;256-63.

Sabale U, Patankar AM. A study of maternal and perinatal outcome in referred obstetrics cases. J Evol Med Dent Sci. 2015;4(26):4448-55.

Park K. Textbook of preventive and social medicine 17th ed. India: Banarasidas Bhanoj Publishers; 2000:632.

Downloads

Published

2021-12-28

Issue

Section

Original Research Articles