AN ANALYTICAL STUDY ON OBSTETRICS REFERRAL CAUSES AND THEIR OUTCOME AT A TERTIARY CARE CENTRE OF NORTHERN MADHYA PRADESH

Background: Pregnancy and child birth especially in high risk women necessitate proper antenatal, intranatal and immediate post partum care. Lack of knowledge, ignorance and poor transport facilities are major contributors of poor pregnancy outcome .Early detection of complications and prompt referral to higher centre is crucial in improving maternal outcome .Aims & Objective: The aim of the study was evaluation of the causes of obstetric referrals and their outcome in our hospitals. Materials and Methods: A retrospective observational study was conducted in the Department of Obstetrics and Gynecology Bundelkhand Medical College Sagar, Madhya Pradesh India .All the referred obstetrics case from 1january 2022 to 31st December 2022 were evaluated and analyzed. All the referred cases of obstetric indications >28 week s of gestation were analyzed for reason of referral and their outcome. Results: Obstetric referral accounted for 52% of the total obstetric admission (3510/6751).The maximum number of patients between 21-30 years age group (83.5%) and majority being primigravida (54%).The major reason for referring patient were hypertensive disorder of pregnancy (39.54%),previous caesarean section (14.84%) and severe Anemia (13.78%) . There were 28 maternal deaths while 98.05% of patient discharged healthy. Conclusion: Lack of knowledge, ignorance and poor transport facilities are major contributors of poor pregnancy outcome .Timely and appropriate referral is crucial in improving maternal outcome. Improvement in the quality of maternal and child health at different tiers of health centre, regular training of health care providers in emergency Obstetrics care is required to curb unnecessary referrals and consequently in reducing maternal morbidity and mortality