MULTIPARAMETRIC STUDY OF OBSTETRIC AND GYNECOLOGICAL EMERGENCY CASES REFERRED TO A TERTIARY CARE CENTER

Background: To analyze the availability of adequate emergency care for obstetric and gynaecological emergencies at health centers at periphery level by a multiparametric study of obstetric and gynaecological emergency cases referred to a tertiary care center. Methods: 250 consecutively referred cases to our tertiary care centre from various peripheral and private hospitals were included in the study and prospectively analysed for the cause of emergency obstetric/gynaecological treatment referral, treatment obtained before arrival, time delays during various points of treatment and impact of these factors on the prognosis of the patient Results: Out of the 250 cases studied, 206 were obstetric referrals while 44 were gynaecological cases. The most common obstetric referral was for better management of patients in active labour (n=83). . Other major obstetric causes included abortion and its related complications (n=38), patients having retained placenta (n=29) and foetal malposition (n=28). The most common gynaecological emergency was menorrhagia (n=22). 41% of cases were referred to us from PHCs from sub-urban areas within a 50 km radius of the city. Conclusion: Four areas of need - cost-barriers to treatment (n=92), non-availability of blood, blood components, and blood transfusion monitoring facilities (n=78), unavailability of certain essential and non-essential but important drugs (n=34) and shortage of 24-hour trained staff (n=54) - can be pinpointed from our study, which, if adequately addressed, would greatly increase the life-saving capability of primary and secondary centres.