To Study Challenges of Interfacility Transfer and Profile of Obstetric Patients Referred to a Tertiary Care Hospital

Objectives: To study challenges of communication and transport in interfacility transfer along with the profile and outcome of obstetric referrals.Methods: This was a prospective observational study.A total of 224 women attending the obstetric emergency, fulfilling inclusion and exclusion criteria were included in the present study.Results: Most of the referred women, i.e., 49.1% were antepartum.A total of 5.3% referred women were critical at arrival and 8% required intensive care unit admission.Maternal mortality occurred in 1.8% cases.There were 1.02% stillbirth and 11.3% neonatal deaths.Only 39.3% women were provided ambulance, and 95.5% referred women reached our hospital from referring hospital within 2 hours.The facilities of en-route stabilization were available in only 4.5% ambulances, and only 1.3% were accompanied by healthcare worker.Also, 2.7% women had two referral units.In only 69.6% cases, referral slips were available and majority (93.6%) were incomplete.Only in two patients, prior information was sent.Conclusion: Most of the obstetric complications develop during antepartum period.Health facilities do not have assured referral transport linkage.Referral slips are usually incomplete, and no communication about the referred case is provided to the referral institution.This leads to increased maternal and perinatal morbidity and mortality.