Referrals revisited: a clinical audit

Authors

  • Swati Dubey Department of Obstetrics and Gynecology, Babu Jagjiwan Ram Memorial Hospital, Jahangirpuri, New Delhi, India
  • Sumita Mehta Department of Obstetrics and Gynecology, Babu Jagjiwan Ram Memorial Hospital, Jahangirpuri, New Delhi, India
  • Sonam Singh Department of Obstetrics and Gynecology, Babu Jagjiwan Ram Memorial Hospital, Jahangirpuri, New Delhi, India
  • Anshul Rohatgi Department of Obstetrics and Gynecology, Babu Jagjiwan Ram Memorial Hospital, Jahangirpuri, New Delhi, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20175036

Keywords:

Barrier in referral service, High risk pregnancy, Obstetric referral, Referral protocol

Abstract

Background: Pregnancy and childbirth are physiological processes; however, severe maternal morbidity can complicate certain pregnancies, deliveries and puerperium. To prevent maternal/ neonatal morbidity and mortality, the high-risk category needs timely identification and intervention and if required, prompt referral to higher centres where HDU/ICU level of care is provided. The present study was a clinical audit of obstetric referrals.

Methods: A clinical audit of all obstetrics referrals done at BJRM (secondary level facility) from 1st May to 31st October 2016. The cases were analysed with respect to demographics, indications for referral and barrier to services.

Results: Referral rate of our hospital was 6.52%. Mean age of women referred was 24.16 years. The associated risk factors were PIH in 36.17%, anaemia in 34.04%, followed by thrombocytopenia and diabetes in pregnancy. Majority of referrals were done in women during labour 93.94% while only 3.03% referrals during post-partum period. Most common indication was MSL with foetal distress 20.96%, followed by hypertensive disorders in pregnancy 16.93%. Other indications were APH, malpresentation, 2nd stage arrest and cord prolapse. The main barriers to providing services at our institute were unavailability of 24 hours OT services, blood bank and ICU care.

Conclusions: Standard referral protocol and well-defined linkages need to be established so as to have better co-ordination between the referral units and tertiary centres.

Author Biographies

Sumita Mehta, Department of Obstetrics and Gynecology, Babu Jagjiwan Ram Memorial Hospital, Jahangirpuri, New Delhi, India

 

 

Sonam Singh, Department of Obstetrics and Gynecology, Babu Jagjiwan Ram Memorial Hospital, Jahangirpuri, New Delhi, India

 

 

Anshul Rohatgi, Department of Obstetrics and Gynecology, Babu Jagjiwan Ram Memorial Hospital, Jahangirpuri, New Delhi, India

DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY

SPECIALIST

 

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Published

2017-10-28

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Original Research Articles