Fetomaternal Outcome in Referral Obstetric Patients in Tertiary Care Hospital

Nayak, Arun; Khade, Shweta Avinash; Pandya, Shriya P; Sarmalkar, Meenal

doi:10.5005/jp-journals-10006-1934

Cited by 3 publications

(4 citation statements)

References 10 publications

(13 reference statements)

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“…98% of the babies in the present study had live births as compared to other similar studies by Shenoy HT et al 20 (85%) and Devineni et al 21 (78%). The stillbirth rate in the present study was 0.4% which was much less than studies from West Bengal (5%) 8 or Mumbai (4.9%) 22 suggesting excellent delivery services by the teaching hospital. The present study reported the need for NICU admission in about 9% of the babies delivered.…”

Section: Discussioncontrasting

confidence: 75%

A Retrospective Record-Based Study to Identify the Indications and Outcomes of Obstetric Referrals to A Tertiary Care Centre in Gujarat, India

Mehta,

Govani,

Jogia

et al. 2024

Natl J Community Med

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Background: Obstetric referral services in the public health system play a crucial role in managing obstetric emergencies. However obstetric referrals to tertiary care centres should be used judiciously and effectively and not convenience-based. Objectives: To study the indications of obstetric referrals from primary and secondary care centres and to assess the referral communications and outcome of referred mothers. Methods: This was a retrospective record-based study done at a tertiary care centre in Gujarat from January to December 2022. All obstetric referrals during the study period were included in the study. Non-obstetric referrals and registered antenatal cases were excluded from the study. Results: Of 1227 mothers referred 62.7% were referred from CHC and 34.7% from SDH. 96.7% of them were referred to in the first stage of labour. There was no pre-referral communication in about 44% of referrals. Referral slip was incomplete in 15% of the mothers. Two-thirds of them had normal delivery (64.5%). Only 3.7% of mothers needed ICU support. 97.91% of the mothers had live births. Conclusion: Unjustified, unindicated, and convenience-based referrals from peripheral health centres and poor referral communication were noted. This study highlights the need for formulation, implementation and monitoring of an obstetric referral policy to avoid clogging tertiary care centres with patients that can be managed at peripheral health centres.

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Section: Discussioncontrasting

confidence: 75%

A Retrospective Record-Based Study to Identify the Indications and Outcomes of Obstetric Referrals to A Tertiary Care Centre in Gujarat, India

Mehta,

Govani,

Jogia

et al. 2024

Natl J Community Med

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“…In our study, majority of the women (52.8%) belonged to the age group of 21-30 years, however there was no ~ 116 ~ significant difference in the age groups when compared in the different categories of gestational age postdate. Other studies with similar categorization of maternal age group of 20-30 years have reported 85% [28] , 69% [29] , and 64% [30] . Some other studies used the age category of 20-35 years and reported 89.4% [31] , 85.3% [32] , and 80.2% [33] .…”

Section: Discussionmentioning

confidence: 62%

“…The main maternal complication recorded in our study was PPH (19.4%) followed by maternal birth trauma (2.2%). Onyebuchi et al [10] also reported PPH as their primary maternal complication in 6.8%, and Botcha et al [28] reported PPH in 6%. Bhriegu et al [38] reported maternal complications of perineal tear and also PPH.…”

Section: Discussionmentioning

confidence: 97%

“…Some other studies used the age category of 20-35 years and reported 89.4% [31] , 85.3% [32] , and 80.2% [33] . Nulliparity is a recognized risk factor for postdate pregnancy [1] and various studies have reported incidence of 55.7% [10] , 63% [26] , and 74% [28] among primigravida. In contrast, this study found a higher prevalence among multiparous women, similar to reports of 53.29% and 54% by Chhetri et al [31] and Naz et al [34] .…”

Section: Discussionmentioning

confidence: 99%

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Maternal and fetal outcomes of pregnancies beyond 40 weeks of gestation at a tertiary care hospital in Port Harcourt, Nigeria

Awoyesuku,

Ohaka,

Amadi

et al. 2023

Int. J. Clin. Obstet. Gynaecol.

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Background: Pregnancy beyond 40 weeks is a frequent dilemma faced by obstetricians as the risk to the mother and the fetus increases with advancing gestational age. This risk becomes more evident as the pregnancy goes beyond 42 weeks.Objective: This study aimed to determine the prevalence of postdate pregnancy and to evaluate the maternal and fetal outcomes at a tertiary care hospital. Methods: A retrospective study was conducted over a two-year period from 1 st May 2021 to 30 th April 2023. The study population were women who were delivered after 40 weeks of gestation. Information was extracted from the hospital records using a proforma. Data were analyzed with SPSS for Windows version 23 and presented using frequency tables, as number and percentages. Statistical analysis was performed using the Chi-square test or Fisher's exact test as appropriate, and the level of significance was set at P value of 0.05. Independent variables were analyzed using bivariate analysis, and the variables with an association were fitted into a multivariate logistic regression analysis. Results: The prevalence of postdate pregnancy was 9.0%. Vaginal delivery occurred in 53.2% whereas 46.8% required caesarean delivery, the most common indication being cephalopelvic disproportion 53.1%, and the proportion increased with increase in gestational age. The stillbirth rate was 3.2% and the perinatal asphyxia rate was 7.6%, both increased with increasing gestational age. The gestational age ≥42 weeks was associated with a four-fold increased risk of caesarean delivery and seven-fold increased risk of stillbirth. Conclusion: Postdate pregnancy was significantly associated with poor maternal outcome in the form of increased caesarean delivery rates, primarily due to cephalopelvic disproportion and fetal distress. Perinatal mortality was high, and fetal complications, especially perinatal asphyxia resulted in higher rate of admission to neonatal intensive care unit.

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Pattern of Referral of Obstetric Patients at a Tertiary Care Hospital in Southern Nigeria

John,

Alegbeleye

2024

ARSci

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Background: Health challenges that are difficult to manage at primary health centres should be referred to secondary health facilities, and if untreated, to the tertiary hospitals. A good referral should include the patient's biography, such as age, gender, tribe, religion, occupation, medical history, the reason for the referral, treatments received, and clinical diagnosis. Objectives: To evaluate the referral patterns, indications for referrals, and feto-maternal outcomes for obstetric patients who were referred to the University of Port Harcourt Teaching Hospital. Materials and Methods: A prospective study of patients admitted to the Obstetric unit from January 1, 2021, to December 31, 2022. Data was collected from patients while on admission or clinic visits and recorded in an excel spread sheet. Data was analyzed with the Statistical Package for Social Sciences (SPSS) version 25. Results: Of the 3469 patients were admitted to the obstetric unit, 1476 and 1993 were admitted in 2021 and 2022, respectively. Most (70.35%) of the patients were in the 20-34 years age group, parity 1-4 was the most frequent (66.49%), while 85.39% of patients were booked. 10.46% of the booked patients were referred from other facilities, whereas 89.54% of patients were booked at our facility from the onset. Most common indications of referrals were previous caesarean section (CS) at term (40.09%) and hypertensive disorders of pregnancy (17.59%). The outcome for 2021 indicated 17 maternal deaths, 132 fetal deaths and 1010 live births, giving maternal mortality ratio (MMR) as 1810.44 per 100,000 live births and perinatal mortality ratio (PMR) of 130.7 per 1000 births respectively. In 2022, there were 17 maternal deaths, 130 fetal deaths and 1297 deliveries, giving a MMR of 1399 per 100,000 live births and a PMR of 100.2 per 1000 births. Conclusion: The pattern of referral among obstetric patients in this study shows that a lot of the patients do not get adequate care at the lower cadre of the referral system, hence adequate facilities should be made available in primary and secondary health centres to tackle obstetric emergencies.

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Fetomaternal Outcome in Referral Obstetric Patients in Tertiary Care Hospital

Cited by 3 publications

References 10 publications

A Retrospective Record-Based Study to Identify the Indications and Outcomes of Obstetric Referrals to A Tertiary Care Centre in Gujarat, India

A Retrospective Record-Based Study to Identify the Indications and Outcomes of Obstetric Referrals to A Tertiary Care Centre in Gujarat, India

Maternal and fetal outcomes of pregnancies beyond 40 weeks of gestation at a tertiary care hospital in Port Harcourt, Nigeria

Pattern of Referral of Obstetric Patients at a Tertiary Care Hospital in Southern Nigeria

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