Spectrum of Obstetrics ase Referrals

Asmita Ghimire; Reshika  Shrestha; Jeshika  Yadav; Ishwor  Thapaliya; Sangrila  Sapkota; Susmita  Khatiwoda; Neebha Ojha

doi:10.33314/jnhrc.v23i01.5316

Asmita Ghimire Department of Obstetrics and Gynaecology, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal. https://orcid.org/0000-0002-3739-386X
Reshika Shrestha Maharajgunj Medical Campus, Institute of Medicine, Maharajgunj, Kathmandu, Nepal. https://orcid.org/0009-0002-0970-1543
Jeshika Yadav Maharajgunj Medical Campus, Institute of Medicine, Maharajgunj, Kathmandu, Nepal. https://orcid.org/0009-0005-3492-9111
Ishwor Thapaliya Maharajgunj Medical Campus, Institute of Medicine, Maharajgunj, Kathmandu, Nepal. https://orcid.org/0009-0001-4980-0186
Sangrila Sapkota Maharajgunj Medical Campus, Institute of Medicine, Maharajgunj, Kathmandu, Nepal. https://orcid.org/0009-0004-6772-9629
Susmita Khatiwoda Maharajgunj Medical Campus, Institute of Medicine, Maharajgunj, Kathmandu, Nepal. https://orcid.org/0009-0005-0952-1069
Neebha Ojha Department of Obstetrics and Gynaecology, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal. https://orcid.org/0000-0003-3518-2425

DOI: https://doi.org/10.33314/jnhrc.v23i01.5316

Abstract

Background: Maternal health is an important focus for ensuring the well-being of both mothers and their babies. Maternal and fetal mortality which is a burning issue especially in third world countries can be reduced significantly with right obstetric referral. This study reviewed the primary reasons, time, distance, and pattern of obstetric cases referred to a tertiary center.

Methods: This descriptive study was conducted after taking ethical approval {Approval number 136 (6-11) E2} from the review board of Maharajgunj Medical Campus, Nepal, and data of three years from 1st August 2020- 31st September 2023 were analyzed from medical records. The study included all referral cases aged 18-45 years who were past 28 weeks of gestation till 42 days post-delivery. Women who had incomplete medical records were excluded from the study. A continuous convenience sampling method was used. The point estimate was calculated at a 95% confidence interval.

Results: Among 174 referred cases, 84 (48.28%) were from the government district-level hospitals with the predominant reason being medical disorders complicating pregnancy 136 (78.17%). The majority of cases 94 (54.02%) were referred during the intrapartum period.

Conclusions: Medical disorders complicating pregnancy were the primary cause for the referral in obstetrics cases, notably from district-level hospitals having less manpower to deal with those cases.

Keywords: Hospital; maternal mortality; obstetric; pregnancy; referrals.