Maternal outcomes among emergency obstetric admissions at a tertiary care teaching hospital in Chitradurga, South India

Anju Arpana, Rashmi B. M., Latha V.


Background: The maternal mortality is a vital index of the quality and efficiency of obstetric services prevailing in a country. The obstetric emergencies are unexpected occurrences during pregnancy or puerperium requiring immediate attention. Obstetric emergencies can either happen suddenly or they can develop as a result of complications that are not properly identified, monitored or managed. These emergencies, to a large extent, are preventable. The purpose of this study was to understand the contributing factors of obstetric emergencies, their clinical presentation, management and maternal outcomes.

Methods: A cross sectional study was conducted among obstetric emergency admissions during October 2016 to September 2017, at a tertiary care hospital in urban area of central Karnataka.

Results: A total of 100 emergency admissions were observed in the study period. A 41% of were un-booked antenatal cases. A 13% of patients reached with the longest delay of 10-12 hours duration. A 31% of emergency admissions were in compromised condition. The majority of the cases were delivered by LSCS (55%).

Conclusions: In the study, nearly half of the pregnancies were unbooked. There were teenage pregnancies reported in the study. More than half of obstetric emergencies were from rural areas. In nearly 50% of admissions a delay of more than 5 hours in reaching this hospital was noted. Ignorance was a major factor which impeded the access of antenatal health care services. Health education to pregnant women about importance of accessing maternal health services, early ANC booking and regular checkups, identification of high-risk pregnancy and timely referral, availability of fully functional first referral units and transport facilities for these emergency patients. Availability of skilled medical professionals round the clock in these FRU’s are the need of the hour.


Delay in seeking health care, Maternal morbidity, Maternal mortality, Obstetric emergencies, Obstetric referral

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Campbell S, Lee C. Obstetric Emergencies. In: Obstetrics by Ten Teachers. Arnold Publishers; 2013:303-317.

Singh S, Doyle P, Campbell O, Rao G, Murthy G. Transport of pregnant women and obstetric emergencies in India: An analysis of the ‘108’ ambulance service system data. BMC Pregn Childbirth. 2016;16:1-11.

Bang RA, Bang AT, Reddy MH, Deshmukh MD, Baitule SB, Filippi V. Maternal morbidity during labour and the puerperium in rural homes and the need for medical attention: A prospective observational study in Gadchiroli, India. BJOG. 2004;111:231-8.

Killewo J, Anwar I, Bashir I, Yunus M, Chakraborty J. Perceived Delay in Healthcare-seeking for episodes of serious illness and its implications for safe motherhood interventions in rural Bangladesh. J Health Popul Nutr. 2006;24(4):403-12.

Salam A, Siddiqui SA. Socioeconomic inequalities in use of delivery care services in India. J Obstet Gynecol India. 2006;56(2):123-7.

Pandve H, Giri P. First referral units (FRU): needs focus in Indian context. Int J Community Med Public Heal. 2015;2(2):75-6.

Bhatt R. Maternal mortality in india - FOGSI-WHO study. J Obstet Gynaecol India. 1997;207-14.

Singh T, Sharma S, Nagesh S. Socio-economic status scales updated for 2017. Int J Res Med Sci. 2017;5(7):3264-7.

Mahavarkar S, Madhu C, Mule V. A comparative study of teenage pregnancy. J Obstet Gynaecol (Lahore). 2008;28(6):604-7.

Rupakala BM, Shruthi AG, Nagarathnamma R. A study on teenage pregnancy and its maternal and fetal outcome. Int J Sci Res. 2016;5(5):2486-9.

Narwadkar M, Sakhare A, Mahale A. Critical study of referrals in obstetric emergencies. J Obstet Gynecol India. 2004;258-9.

Kaye D, Mirembe F, Aziga F, Namulema B. Maternal mortality and associated near-misses among emergency intrapartum obstetric referrals in Mulago hospital, Kampala, Uganda. East Africa Med J. 2003;80(3):144-9.

Irene YV, Vaneet K, Gurvinder K, Arun A, Lalita A. Critical care in obstetrics - scenario in a developing country. J Obstet Gynecol India. 2008;58(3):5-8.

Goswami P, Bindal J, Chug N. To study pattern of obstetric cases referred at tertiary care centre in Central India. Int J Reprod Contracept Obstet Gynecol. 2017;6(6):2370-4.

Thaker R, Deliwala K, Jadav M. Retrospective comparative study of obstetric complications and maternal mortality in registered and unregistered women at tertiary care hospital. NHL J Med Sci. 2013;2(1):28-35.

Guguloth K, Sivaranjani B. A retrospective study of maternal and perinatal outcome in obstetrical emergencies at government general hospital, Guntur. IOSR J Dent Med Sci. 2016;15(12):26-31.

Sharada M, Radhakrishnan J, Panigrahi P. Analysis of 100 cases of Obstetric Emergencies needing critical care in referral centres like steel plant hospitals. J Obstet Gynaecol India. 2001;51(6):87-90.

Upadhyaya I, Chaudhary P. Severe acute maternal morbidity and intensive care in Paropakar maternity and women’s hospital. Nep J Obs Gynaecol. 2013;8(2):38-41.

Saha R, Gautam P. Obstetric emergencies: feto-maternal outcome at a teaching hospital. NJOG. 2014;17(1):37-40.

Sabale U, Patankar A. Study of maternal and perinatal outcome in referred obstetric cases. J Evol Med Dent Sci. 2015;4(26):4448-55.

Bindal J, Sharma DC. Overview of referred obstetric patients and their outcome in tertiary care hospital. J Med Sci Clinic Res. 2017;5(5):22485-91.

Poornima M, Daver R. Maternal and fetal outcome in obstetric referred cases. Global J Res Analysis. 2018;7(2):544-7.