Outcome of Women Referred with Postcaesarean Complication in a Tertiary Care Centre in North India: A Retrospective Study

Introduction: Rate of Caesarean Sections (CS) has increased over the last few decades. There is an increased referral of women with postcaesarean complications. Aim: To evaluate the outcome of women with postcaesarean complications. Materials and Methods: This retrospective study was conducted at the Department of Obstetrics and Gynaecology, King George's Medical University Lucknow, India over six months from August 2018 to January 2019. All the women referred with postcaesarean complications were included in the study. Women who had complications following CS performed at the centre were excluded. Demographic variables including age, socio-economic status, literacy, number of antenatal visits, indication for CS. The type of complication, number of places visited before admission, the interval between complication and admission, availability of referral documents, interventions required and outcome was noted. Chi- squared tests were used to test for statistical significance. The p-value was considered to be significant if <0.05. Analysis was done using Statistical Package for the Social Sciences (SPSS) software 20.0. Results: Total women enrolled were 146, with mean age of women was 27.69 +/- 4.7 years. The youngest woman was 19 years, while the oldest was 36 years. Total 60.2% (88/146) women were referred from government centres, and the majority of women (82.18%) reached tertiary centres directly and had a referral document. The interval between complication and admission was within 24 hours in only 55 (37.66%) women. The most common reason for referral was septicaemia (39,26.71%), followed by Postpartum Hemorrhage (PPH) (27,18.49%). Mortality was seen in 35,24.6 % of women. Conclusion: Most women referred with postcaesarean complications were from the public health system with appropriate referral procedures. Timely referral after detection of complications will improve maternal outcome.