High risk neonates and referral pattern to a secondary level care rural based hospital in south india

The CMCH is situaled south of Chennai, 55 Kms away from the capital city of Tamilnadu. CMCH caters to rural population from Kancheepuram district and Chengalpattu Taluk with a population of 10,78,190. High-risk cases are referred from 4 peripheral hospitals (lHead Quarters & 3 Taluks), 24 Primary health care centers and also from home by the Traditional Birth Attendants. Aim of the Study: To investigate into the reasons for referral from primaıy health centers and Taluk hospitals to the secondary care center and to study the high-risk deliveries and the perinatal outcome.

Yöntem

The study was carried out at CMCH from January 1st - December 31st 2000-2001. it was a retrospective study using the existing records in the labour room, and neonatal ward by trained persons under the supervision of the pediatrician in the neonatal unit. The information pertaining to the condition at the time of admission, mode of delivery, the place from where the cases are referred, the distance from home to the place of delivery, mode of delivery were recorded. The STATA version 5 was used to analyze the results.

Bulgular

30% of the mother had to travel more than lOKms to reach the PHC, and 36% had to travel more than 20 Kms from home.68% come from linked villages. in this study 30-40% were high-risk mothers, and 7-8%) had more than one complication. Nearly 40% of mothers had CPD or previous history of cesarean section. 20% had prolonged 2nd stage with fetal distress, 12% had premature rııpture of membranes, 11% were non vertex presentation, and 11% arrived al a critical state with threatened rupture.

Sonuç

Neonatal care is not affordable to many developing nations, early refenal to the center with adequate facilities can prevent perinatal deaths in developing nations.

Anahtar Kelimeler

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