Outcome of Referred Obstetric Patients in Paropakar Maternity and Womens Hospital.

BACKGROUND

Lack of a structured referral system is a challenging hurdle in developing countries like Nepal that delays in management. Identification causes of delays and their timely management is of immense importance. The study aimed to assess the maternal and fetal outcome of referred-in obstetric patients and to identify various maternal determinants of referrals inParopakar Maternity and Women's Hospital.

METHODS

A prospective study was conducted during 3 months duration from May to June 2021 among undelivered obstetric cases who were referred to Paropakar Maternity and Women's Hospital. Study excluded self-referrals, without referral slips and postpartum patients. Maternal determinants, mode of management, maternal and fetal outcomes were noted.

RESULTS

Out of 47 cases enrolled, most common diagnosis of referral was hypertensive disorder accounting for 19.14% followed by intrauterine growth restriction comprising 10.6%. Of total, 55.3% of referred patients were from the district hospitals. Ambulances rescued 78.7% of cases and 10.6% were rescued by helicopter. About 12.7% of the referred cases required intensive care management. Live birth were 86.3%, still birth 4.5% and 9.1% of Intrauterine Fetal Death.

CONCLUSIONS

Among the varied high risk cases, most common diagnosis at the time of referral was hypertensive disorders followed by cases requiring critical care and surgical management. This highlights need and scope of strengthening emergency obstetric care centres and early identification and treatment of high risk cases antenatally at every level of health centres.