Pattern,maternal and perinatal outcome of institutional referal cases at mizan aman general hospital

Abstract

Background: Every two minute, one maternal death occur somewhere in the developing world. Every year over half a million woman die during pregnancy and following childbirth. Almost three-quarters of maternal deaths are due to direct causes, clustered around the time of labour and delivery, and are preventable with timely access to skilled emergency obstetric care. An estimated 15% of all pregnancies will encounter complications; 7% will be serious enough to require referral to a higher level of care. The first referral level is defined as district or subdistrict hospital, to which a woman at high risk is referred prenatally or sent for emergency obstetric care. So, linking the different levels of care was an essential element of primary health care (PHC) from the very beginning.2 Objectives:-the study was try to identify the pattern, maternal and perinatal outcomes of institutional referral at Mizan Aman general hospital Methods: Facility based retrospective study was conducted at Mizan Aman General Hospital ,Mizan Aman town, Ethiopia from June 1 2013 to June 12014G.C. All referral cases in the specified time were included in the study. Secondary data was collected using structured checklists by trained data collectors. The collected data was checked for its completeness, entered, edited, cleaned and the mean, mode, proportion, percentage & variance of different variables analyzed by SPSS. Results: In this study most of the studied groups age fall under the category 18-35 (96 %). Out of all data scrutinized obstetric referral cases prolonged labor (40%), fetal distress (16%), PROM (16%) and IUFD (8%) comes in the first line of referring reasons. Unlike the frontiers, while the others like, previous CS history (6%) CPD (4%), PIH (4%) in a descending order are the less likely referring reasons in the locality of Aman-Mizan General Hospital. Besides, among 450 cases referred to Aman-Mizan general hospital from nearby health facility during one year period with this finding revealed, the utilization of pantograph were seen as low as 80%. Of all the cases, undertaken as professional intervention, Spontaneous vaginal delivery (SVD) takes the first place scoring 252(56%). While, vacuum delivery 18 cases (4%) forceps 46 cases (10.2%), hysterectomy 10 (2.2%) destructive delivery 9 (2%) cesarean section 115 (25.6%) methods were used accordingly. In this study only two (0.44%) of maternal death were caused by PPH. Though there is improved ANC and delivery care PPH still pose great threat to maternal mortality. Conclusion and recommendations: The most frequent referral case during this study period were prolonged labor, fetal distress, PROM and IUFD and there were two (.22) maternal and 36(18%) perinatal death. Almost half referral and hospital diagnosis is in agreement. Early referral, a well linked feedback and skilled care during antenatal, labour and delivery put as recommendation.