Indian Journal of Obstetrics and Gynecology Research


A prospective study of spectrum & outcomes of obstetric referral patterns in a tertiary care centre in central Karnataka


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Article Type : Research Article

Author Details: Bandamma Narendra S*,Aditi Shree

Volume : 6

Issue : 3

Online ISSN : 2394-2754

Print ISSN : 2394-2746

Article First Page : 251

Article End Page : 254


Abstract

Introduction and Objectives: The women in reproductive age group of 15-45 years are vulnerable
and at risk due to obstetric emergencies. 92% of maternal deaths are due to delay in referral and case
management. 1 Hence for providing essential obstetric care, referral system needs to be strengthened. This
study is aimed at reviewing the primary reasons and pattern of obstetric cases referred to a tertiary care
centre and management of its complications.
Design: It is a prospective observational analysis of antenatal/post-partum patients over a period of 1-year
in a multi-disciplinary intensive care unit (ICU) at a tertiary care centre. We studied 50 patients.
Results: 76% of the patients in this study were referred from peripheral health centres. 77.34% patients
had obstetric complications. Commonest risk factor for ICU admission was hypertensive disorders of
pregnancy and obstetric haemorrhage. Other major risk factors were heart disease and sepsis. Major cause
of maternal mortality was multi-organ-dysfunction and sepsis secondary to massive obstetric haemorrhage.
Conclusion: The multi-disciplinary team approach in intensive care units, close monitoring, symptomatic
treatment, prompt surgical intervention and safe motherhood initiative would reduce the current Maternal
Mortality Rate. Development of standard referral protocol, availability of tertiary care, proper training in
this regard is much needed.

Keywords: Obstetric emergencies, Referral system, Intensive care units.

Doi :-https://doi.org/10.18231/j.ijogr.2019.058