Evaluation of maternal care at different level of health care facilities and referral scenario in Northern Madhya Pradesh and its effect on fetomaternal outcome

Abstract

Background: Pregnancy and childbirth especially in high-risk women necessitate proper antenatal, intranasal and immediate post partum care. Lack of knowledge, ignorance and poor transport facilities are major contributors of poor pregnancy outcome. Early detection of complications and prompt referral to higher centre is crucial in improving maternal outcome. Methods: This retrospective observational study was conducted in 700 consecutive patients who attended the department of obstetrics and gynecology Bundelkhand medical college, Sagar Madhya Pradesh. India from 1st January 2021 to 30th July 2022. Results: Out of total patients included maximum referrals were from CHC (community health centre) i.e., 49%, followed by 25.5 and 14.6% referrals from DH (district hospital) and PHC (primary health centre) respectively. Majority of referrals from outside located CHC from Sagar district. Maximum referral reported during third trimester i.e., 58.4 and 79.2% from inside and outside Sagar respectively. Overall majority of patients referred belonged to the age group of 21 to 30 years (76.6%) and there was not significant (p=0.41) correlation between inside and outside referral. Conclusions: Maximum referrals reported during third trimester i.e., 58.4% and 79.2% from inside and outside Sagar Districts respectively and there was statistically significant correlation (p=0.01). Antenatal care (ANC) outcome at tertiary health centre can be improved by up grading health care facilities at various peripheral health care centres.