Pattern of Referral Cases to the Obstetrics Unit of the Rivers State University Teaching Hospital for Maternal Delivery

Abstract

Background: Formal education, antenatal care, and improved health services still remain the key to a large-scale reduction in maternal mortality in developing countries. Pregnancy and labour complications are most prevalent among unbooked patients compared to booked patients. Prompt and effective treatment will go a long way to reduce these complications. Objective: To determine the pattern of Obstetric referral cases to the Rivers State University Teaching Hospital (RSUTH) and assess time to response by the hospital. Methodology: A retrospective review of hospital records of all pregnant women referred to RSUTH for maternal delivery and care in a six months period, 1st April to 30th September 2015, was carried out. Data on patients’ age, educational level, marital status, gestational age, parity, booking status, time interval between admission and intervention, obstetric diagnoses and outcome were retrieved using structured pro-forma. Data were analyzed using United States CDC Epi Info Version 7. Results: There were 460 cases referred to the hospital, which represents 42.6% of all maternal deliveries, with a mean age of 28.7±4.6 years and median age of 27.0 years. A majority, 73.7% had secondary education, 55.4% were Primigravidae, 55.4% had term pregnancies and 77.8% were booked elsewhere. Over 60% of diagnoses comprised of difficult labour, Pre-eclampsia/ Eclampsia and prolonged pregnancy. About 75% of the cases had intervention carried out within 12 hours of arrival to hospital. Conclusion: The pattern of referral cases to our hospital are mainly young educated primigravidae at term, who have had some form of antenatal care and presenting with common complications associated with this group. The intervention response time is good, but we recommend that high risk pregnancies should ab initio be registered at centers properly equipped to handle such cases to avoid calamity.