Volume : VII, Issue : II, February - 2018

Maternal And Fetal Outcome In Obstetric Referred Cases

Dr. Poornima M, Dr. Rekha G Daver

Abstract :

 

Background:

Pregnancy and childbirth though physiological processes are not free from risks. Despite considerable advances in obstetric care maternal morbidity and mortality remains a major challenge faced by an obstetrician. As protocol based obstetric practice is becoming more common there are many patients who are referred from periphery to a tertiary care hospital for deliveries. Identification and referral of high risk pregnancies is one of the crucial steps in preventing maternal as well as neonatal morbidity and mortality since any undue delay a patient may affect maternal as well as neonatal outcome most severe of which is maternal or neonatal mortality. The aim of this study was to study the pattern of obstetric cases referred to tertiary care centre and to study the maternal and fetal outcome in these cases.

Aims and Objectives:

To study the maternal and fetal outcome in the referred obstetrics cases.

Materials and Methods:

After obtaining approval from institutional ethical committee we conducted a prospective study of 332 who were referred from other government, private or peripheral hospitals to our centre. Patients were enrolled in the study on the basis of a predefined inclusion criteria. Those patients who had any exclusion criteria were excluded from the study. A detailed clinical history, place from which patients were referred, type of transport used, causes of referral were studied. Physical and obstetric examination was done and relevant investigations were done. Management of the patient, course in ward, mode of delivery (i.e. whether vaginal or LSCS), maternal and neonatal outcome was documented. Causes of maternal mortality and morbidity were analysed. Neonatal outcome was assessed by incidence of low birth weight, premature delivery, stillbirths, NICU admissions and mortality during neonatal period. The data was tabulated and analysed using SPSS 16.0 version software.

Results:

Total 332 obstetrics patients referred to our hospital were included in this study. Out of 265 patients who were delivered at our institute 149 (56%) patients underwent normal vaginal delivery while LSCS was done in 116 (44%) patients. The common indications for LSCS included previous LSCS (37/116), Fetal Distress (19/116) and pregnancy induced hypertension and its complications (18%). 98 (27 %) patients were at risk of maternal mortality. Blood transfusions and CCU admissions were required in 20 % and 10% patients respectively. Maternal mortality was seen in 26 (7%) patients. The common causes of maternal mortality included medical disorders complicating pregnancy (31%) followed by Pregnancy induced hypertension (19%) and post party haemorrhage (16 %).There were 27 (9.71%) stillbirths while NICU admissions and neonatal deaths in NICU admitted neonates were seen in 68 and 22 patients respectively. Out of the studied cases 265 (80%) patients were delivered in our institute and out of remaining 67 patients 38 (11%) were discharged before delivery and 29 (9%) patients either aborted or were having ectopic pregnancy.

Conclusion:

Referral to a higher centre is a critical step in management of obstetrics cases. Proper referral at an appropriate time may be associated with decreased maternal and neonatal morbidity and mortality.

Keywords :

Article: Download PDF    DOI : https://www.doi.org/10.36106/gjra  

Cite This Article:

Dr. Poornima M, Dr. Rekha G Daver, Maternal And Fetal Outcome In Obstetric Referred Cases, GLOBAL JOURNAL FOR RESEARCH ANALYSIS : VOLUME-7, ISSUE-2, FEBRUARY-2018

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