Referral of obstetric cases: Reasons and outcome in a tertiary care setting in Sukkur, Sindh.

Abstract

Introduction: The onset of pregnancy till its culmination is a critical care period for the mother because any negligence during the nine months can have dire consequences both for the mother and the child.
 Objective: The objective of this study is to document the reasons for which women at the time of delivery are referred and their outcome for both mother and new born.
 Methodology: A cross-sectional study was conducted in the Obstetrics and Gynaecology Unit 1, Department of a tertiary care teaching hospital in Sukkur, Sindh. Full-term pregnant females who were referred in the period of May 2018 to April 2019 were included. Total referrals accounted for n=99. Data was analysed on SPSS version 23. Frequencies and percentages were calculated for the reasons and the outcome. Kruskal Wallis test was applied for finding differences in mean gestational age among maternal and foetal outcomes. P-value less than 0.05 was taken as significant.
 Results: Total n=99 females were referred during one-year period. The most prevalent medical reason for referral was postpartum haemorrhage (19%) and Eclampsia (18%). Anaemia as an indirect cause was seen in (41%) referrals. For the majority, the mode of delivery was Caesarean Section (49.5%). Maternal deaths were (12%) whereas Intra Uterine Deaths accounted for (41%).
 Conclusion: The most common reason for referral was postpartum haemorrhage and eclampsia. Increase maternal mortality and intrauterine deaths are observed.
 Keywords: Maternal outcome, foetal outcome, referrals, high-risk pregnancies, Anaemia.