Authors : Indranil Dutta, Priyanka Roy, Subhendu Dasgupta, Mahamud Khan, Payel Saha
DOI : 10.18231/j.ijogr.2020.019
Volume : 7
Issue : 1
Year : 2020
Page No : 91-99
Introduction: Referral is essential part of maternal and child services. Major causes of referral to a tertiary
center includes preterm labor, preeclampsia, eclampsia, previous CS, Rh negative blood group, antepartum
hemorrhage, postpartum hemorrhage and sometimes due to lack of manual resources.
Objectives: To identify the primary reasons and pattern of obstetric case referral to our hospital and to
study the maternal and perinatal outcome in those cases.
Materials and Methods: Two Hundred obstetric referred cases of more than 28 weeks gestation admit
ted to IQ City Medical College, Durgapur were analyzed for the maternal and perinatal outcome.
Results: In this study of the total studied patients majority were in the group 21-25 yrs constituting about
72.09%. Of the total studied patients majority of them around 66.1 % are of Socioeconomic class III.
Primigravidas constitute the majority of about 62% of the referral. Majority of the cases about 72% are
booked mostly at government hospitals and only 28% of the cases are unbooked. 38.7% of the referral
was from the areas like Raniganj, Bolpur, Panagarh. About 87.1% of the referral has been made with an
obstetric indication. 12.6% of the referral had medical indication for referral. Only 1.3% of the cases had
lack of manual resource as an indication for referral. Analyzing at the quality of referral according to the
predefined criteria only 55% of the cases had adequate referral whereas about 25% of the cases had poor
referral most of which were from the PHCs. 37.7% of the patients delivered vaginally, with about 62.3%
of the patient delivered by caesarean section. In the present study there were a total of 131 live births, 5
still births and 7 early neonatal deaths making the perinatal mortality rate (PNMR) of 95.23 per 1000 live
births, which shows a much better outcome than the other similar studies. Perinatal outcome was best for
patients with age group 21-25 years and was worst for age group more than 30 years.
Interpretation and Conclusion: Although better than the national data, there is indeed no doubt that rural
health care infrastructure is falling short of the existing requirement. However, educating the population
about the existing health care delivery system and sensitizing the public toward improving maternal and
child health would go a long way in optimally utilizing the existing infrastructure and improving the
maternal and perinatal outcome.
Keywords: Maternal outcome, Perinatal outcome, Referred cases.