ABSTRACT
Objective: to analyze the factors responsible for immediate post-operative (PO) complications after caesarean section (CS) performed in peripheral settings leading to referral to Holy Family Hospital, Rwp, Dept of Obs/Gynae Unit-II.
Study Design and Setting: a prospective observational study was carried out in Holy Family Hospital, Dept of Obs/Gynae Unit-II. Over a period of one year i.e. 2012. All patients referred to Holy Family Hospital with complications in early post-operative period after caesarean sections were included in this study.
Methodology: thirteen patients referred to Obs/Gynae Unit-II in emergency were included in our study. A detailed proforma including history, examination, investigations, source and reasons of referral, indication, timing, place and competency of doctor performing the CS, interval between CS and referral and maternal condition on reaching the hospital were noted. Maternal and neonatal outcome after management in hospital was noted.
Results: out of a total of 13 patients, 31% were managed conservatively, 15.3% required evacuation of retained products of conception 15% needed re-operation. One patient had peripartum hysterectomy. 15% patients died during the course of management. One patient was received dead i.e. 7.6% making a mortality of 31%.
Conclusion: referral rate to tertiary care hospital after CS is rising continuously. CSs carried out in compromised facilities by unskilled / nonprofessionals without any strong indication are a major cause for PO complications. Moreover, no proper referral system and no prior information leads to compromised facilities for these serious patients. Delay in referral is also a big contributory factor for adverse maternal and perinatal outcomes. There is an urgent need of provision of efficient referral system along with 24 hours emergency cover. Obstetric care system with alert transportation should be readily available to women in need.  
Key words: postoperative, Caesarean section, Maternal outcome.

[Download Complete Original Article]
Online Format File Size: 33 KB(PDF)
Printable Format File Size: 2.58 MB(PDF)