DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20221675

Study of feto-maternal outcome in referred obstetric cases in tertiary care center in Rajasthan: a cross sectional study

Ghyan Prakash, Pooja Meena, Suman Meena, Seema Bariya

Abstract


Background: Pregnant women are at high risk for life threatening complications throughout the pregnancy and during delivery as well. Most of these complications are unpredictable with routine clinical examination. Skilled medical interventions such as blood transfusion, caesarean delivery, expert surgical team, medicines etc. are required to prevent these complications. Emergency obstetric referral should be carried out to avoid maternal and fetal morbidity and mortality. Aims and objectives of current study were to investigate the pattern of referral in tertiary care center and fetomaternal outcome in referred cases.

Methods: This is a observational study conducted in the department of obstetrics and gynaecology, at a tertiary care hospital. Patients are referred from nearby PHCs, CHCs, SDHs and private hospitals. All referred antenatal and intra-natal patients to our center of >24 weeks of gestational age were studied.

Results: Majority of them 43% women were of 21-25 year of age, 35% women were of 26-30 year of age group. Out of 76 delivered women, 55% underwent caesarean section and 36.84% were delivered normally. PPH seen in 6.66% patients, maternal deaths reported 2.5%, septicaemia 1.6%, wound gaping in 3.33%, puerperal pyrexia in 5% of patients. 77% neonates were shifted to mother-side, whereas 18% were admitted to NICU.

Conclusions: Referral system is an important part of health care system. By providing good antenatal care, availability of blood products, well organized referral center, timely identification and referral of high-risk patients, skilled birth attendants at time of child birth all will help in reducing feto-maternal morbidity and mortality and will help in achieving goal of ideal MMR and NMR.w


Keywords


MMR, NMR, Referral emergencies, PPH, Feto-maternal outcome

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References


Chatterjee A, Mukherjee J. Emergency obstetric care. J Obstet Gynaecol India. 1998;48(61):31-4.

Brun JL, Billeaud C, Elleav C, Guyon F, Roux D, Dallay D, et al. Maternal transport to the bardeaux university hospital: a retrospective study of 263 cases (1996-1998). J Gynecol Obstet Boil Reprod. 2009;29(14):414-22.

Swain S, Prakash A. utilisation of referral services by high-risk pregnant population in rural Varanasi. Indian J Matern Child Health. 1992;3(3):74-6.

Sabale U, Patanker AM. A Study of maternal and perinatal outcome in Referred Obstetrics cases. J Evol Med Dent Sci. 2015;4(26):4448-55.

The mother-baby package: WHO's guide to saving women's and infants' lives. Safe Mother. 1994;15:4-7.

Sirisha P, Aashritha T. Region wise referrals to a tertiary care center: a retrospective analysis. JRCOG. 2019;8(12):4678-83.

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

Goswami P, Bindal J, Chug N. To study pattern of obstetric cases referred at tertiary care center in central India. Int J Reprod Contracept Obstet Gynecol. 2017;6(6):2370-4.

Patel HC, Singh BB, Moitra M, Kantharia SL: Obstetric referrals scenario at a primary health center in Gujarat. Natl J Community Med. 2012;3(4):711-4

Sakhare AP, Thakare P. Outcome of caesarean delivery in rural obstetric referrals, 51 conference. AICOG. 2008.

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

Sorbye IK, Vangen S, Oneko O, Sundby J, Bergsjo P. Pregnancy and childbirth caesarean section among referred and self-referred birthing women: a cohort study from a tertiary hospital, north eastern Tanzania. BMC. 2011;11(55):1-10.

Nanda LS, Sirohiwal D, Singhal RS, Chauhan M, Sarika A. To study the pattern of maternal and perinatal outcome of referred obstetrics cases in a tertiary care hospital of Northern India. Int J Clin Obstet Gynecol. 2020;4(5):216-9.