Original Research Article DOI: 10.18231/2394-2754.2016.0022 Indian Journal of Obstetrics and Gynecology Research 2016;3(4):397-399 397 Scenario of obstetrical emergencies at a tertiary care hospital Khushpreet Kaur 1 , Parneet Kaur 2 , Surya Malik 3,* 1 Professor, 2 Associate Professor, 3 Junior Resident, Dept. of Obstetrics & Gynecology, *Corresponding Author: Email: surya85.sm@gmail.com Abstract Objective: To study relative preponderance of critical obstetrical emergencies with various maternal factor like quality of antenatal care during pregnancy, regular antenatal checkup during pregnancy, socioeconomic status, education and area wise distribution and to study the contribution of each emergency to maternal mortality and morbidity and fetal outcome. Methods: The present study was conducted on a prospective basis for one year, from 1 st Feb 2011 to 31 st Jan 2012 in the department of Obstetrics and Gynecology Govt. Medical College and Rajindra Hospital, Patiala. All the cases referred as critical emergency from nearby areas during their antenatal period or within 42 days of delivery were included in the study. A detailed history including age, parity, gestational age, antenatal care during pregnancy, socioeconomic status, obstetrical history, medical or surgical disorders was taken into account. Attention was paid on the management received by each case including blood transfusion, surgical interventions, ICU admission etc. Results: Total deliveries during this period were 2223. Total obstetric emergencies came out to be 252. Thus the incidence of obstetric emergencies came out to be 11.3%. Various obstetric emergencies that were encountered – Hemorrhage (47.97%), Hypertensive disorders of pregnancy (35.32%), obstructed labor (12.3%), P. sepsis (3.18%), Rupture uterus (2.78%). Maternal mortality came out to be 8.8% Hemorrhage was leading cause of death in 36.36% cases followed by P. sepsis (13.64%), Hypertensive disorders of pregnancy (13.64%), Rupture uterus (9.09%). There were 70.2% Live births and 29.8% still births. Conclusions: It was concluded that obstetric emergencies are more common in unbooked cases and women with low socioeconomic status with poor access to antenatal care. Introduction An emergency by definition is “an unforeseen combination of circumstances or the resulting state that calls for immediate action.” Despite improvements in prenatal care and advancements in medical technology, the practice of obstetrics will always provide the clinician with “life-or-death” situations that call for immediate response. (1) During the last decade, it has become apparent that a large portion of the young women and children at greatest risk of obstetric and gynecological emergencies increasingly fall out of the health care system. In several areas of the country up to 25% of women receive no prenatal care. In other areas, close to 50% of young women have no primary care providers to handle emergencies. (2) The maternal mortality ratio (MMR), expressed as maternal deaths per 100,000 live births over a given period, is a major measure of quality of obstetric care. (3,4) WHO analysis of cause of maternal death reveals the following causes of Maternal Deaths – Hemorrhage (30.8%), Hypertensive disorders (9.1%), Sepsis/ Infections (11.6%), Obstructed labor (9.4%), Abortion (5.7%), Anemia (12.8%), Other Indirectcauses of death (12.5%), Other direct causes of death (1.6%), Embolism (0.4%) Ectopic pregnancy (0.1%), Unclassified (6.1%). (5) Cases presenting with all these morbid conditions are included in the present study. Material and Methods The present study was conducted on a prospective basis for one year, from 1 st Feb, 2011 to 31 st Jan, 2012 in the department of Obstetrics and Gynecology, Govt. Medical College and Rajindra Hospital, Patiala. All the cases referred as critical emergency from nearby areas during their antenatal period or within 42 days of delivery were included in the study. A detailed history including age, parity, gestational age, antenatal care during pregnancy, socioeconomic status, obstetrical history, medical or surgical disorders were taken into account. A thorough general physical examination, local examination including per abdomen and per vaginum examination was done in every case. All the relevant investigations were done in each and every case. Attention was paid to the management received by each case including blood transfusion, surgical interventions, ICU admission etc. Biochemical evaluation was done by performing routine investigations and Special Investigations e.g. USG, ECG, CT Scan, 24 Hour urinary protein, Pus for C/S, Color Doppler study and Blood Culture whenever required.