Emergency obstetric referrals to a tertiary care centre

Background: Emergency obstetric referrals play a crucial role in reducing maternal and perinatal morbidity and mortality, especially in resource-limited settings. Delays in referral, inadequate stabilization, and poor documentation often compromise outcomes, necessitating evaluation of existing referral systems. Objectives: To evaluate the pattern of emergency obstetric referrals to a tertiary care centre and to assess the final maternal and fetal outcomes of referred cases. Methods: This cross-sectional study was conducted at a tertiary care institution in Secunderabad, Telangana, over an 18-month period from January 2022 to June 2023. A total of 1200 antenatal and postpartum women referred for emergency obstetric care were included. Data were collected prospectively using a structured proforma documenting socio-demographic variables, indications for referral, referral documentation, pre-referral stabilization, management provided, and maternal and neonatal outcomes. Descriptive statistics and appropriate inferential tests were applied using SPSS version 25.0. Results: Most women were aged 21-30 years and belonged to lower socioeconomic strata. Antepartum referrals constituted 62% of cases, with hypertensive disorders of pregnancy being the most common indication. Cesarean section was performed in 58% of cases. ICU admission was required in 22%, and blood transfusion in 67% of women. Although referral slip availability was high, pre-transfer counseling and adequate stabilization were frequently lacking. Neonatal outcomes showed 18.7% NICU admissions and 8% neonatal mortality. Conclusion: Emergency obstetric referrals significantly influence maternal and perinatal outcomes. Strengthening referral protocols, ensuring timely stabilization, improving documentation, and enhancing capacity at peripheral health facilities are essential to optimize outcomes.