Background: Emergency obstetric referrals play a crucial role in reducing maternal and perinatal morbidity and mortality, especially in resource-limited settings. Delays in referral, inadequate stabilization, and poor documentation often compromise outcomes, necessitating evaluation of existing referral systems.
Objectives: To evaluate the pattern of emergency obstetric referrals to a tertiary care centre and to assess the final maternal and fetal outcomes of referred cases.
Methods: This cross-sectional study was conducted at a tertiary care institution in Secunderabad, Telangana, over an 18-month period from January 2022 to June 2023. A total of 1200 antenatal and postpartum women referred for emergency obstetric care were included. Data were collected prospectively using a structured proforma documenting socio-demographic variables, indications for referral, referral documentation, pre-referral stabilization, management provided, and maternal and neonatal outcomes. Descriptive statistics and appropriate inferential tests were applied using SPSS version 25.0.
Results: Most women were aged 21-30 years and belonged to lower socioeconomic strata. Antepartum referrals constituted 62% of cases, with hypertensive disorders of pregnancy being the most common indication. Cesarean section was performed in 58% of cases. ICU admission was required in 22%, and blood transfusion in 67% of women. Although referral slip availability was high, pre-transfer counseling and adequate stabilization were frequently lacking. Neonatal outcomes showed 18.7% NICU admissions and 8% neonatal mortality.
Conclusion: Emergency obstetric referrals significantly influence maternal and perinatal outcomes. Strengthening referral protocols, ensuring timely stabilization, improving documentation, and enhancing capacity at peripheral health facilities are essential to optimize outcomes.
International Journal of Clinical Obstetrics and Gynaecology
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