Study of referred cases in Obstetric and Gynecological practise at a tertiary care hospital in Central India

Background: Referral services for identification & referral of high risk pregnancies are an integral part of maternal and child health services. This study was aimed to incidence of referral cases of obstetrics/gynaecology analyze and to analyse the availability of adequate essential care for obstetric and gynaecological emergencies at health centers at periphery level. Methods: 156 consecutively referred cases at Sri Aurobindo Medical College and PGI, Indore from various peripheral and private hospitals were included in the study and prospectively analysed for the cause of obstetric/gynaecological treatment referral, treatment obtained before arrival, delays during various points of treatment. Results: Out of 156 cases studied, 118 cases (75.64%) were of obstetrics and 38 cases (24.35 %) were of gynaecology. Neonatal ICU care post delivery (n=28, 23.7%) was the most common cause of referral, followed by cases due to obstructed labour (n=27, 22.8 %). Out of 38 cases of gynaecology, maximum cases were of  Ca Ovary (n=15, 39.4%), followed by those of uterire prolapsed (n= 14, 36%). Neonatal mortality in referred cases was observed in 8 cases, while obstetrics deaths were observed in 3 cases. Lack of facilities at peripheral health centre and lack of blood bank facilities were dominant reasons for referring the cases. Conclusion: In view of the above findings, there is need for social and clinical interventions to fill the gaps in the current referring practices, to strengthen and improve quality of services, infrastructure and availability of trained manpower at peripheral health centres. Key words: Referral cases, Obstetrics, Gynaecology, Obstructed labour