European Journal of Cardiovascular Medicine

Obstetric emergencies represent critical situations that pose significant risks to both maternal and fetal health, encompassing conditions such as severe hemorrhage, preeclampsia, eclampsia, and uterine rupture. These emergencies necessitate prompt and efficient medical intervention to stabilise the mother and ensure the best possible outcomes for her and the baby. The urgency of these situations cannot be overstated, as delays or inadequate responses can lead to severe complications or fatalities. Despite considerable advancements in maternal healthcare, including improved prenatal care and advanced medical technologies, obstetric emergencies remain a significant challenge for healthcare systems worldwide ⁽¹⁾

The study will analyze various factors, such as the demographic characteristics of the patients, the nature of the emergencies, the interventions performed, and the outcomes. By identifying patterns and outcomes, the study aims to provide insights that could help improve the management of obstetric emergencies, thereby enhancing the quality of care provided to pregnant women and their babies. The study aims to bridge gaps in knowledge and practice by providing comprehensive insights into obstetric emergencies. It seeks to improve maternal and fetal healthoutcomes through meticulous analysis and evidence-based recommendations, particularly in settings where healthcare resources are constrained. The ultimate goal is to foster safer and healthier pregnancies, ensuring that both mothers and their babies receive the best possible care during these critical times.

The present study was conducted on a prospective basis for one year, from 1st Feb, 2022 to 31st August 2023 in the department of Obstetrics and Gynaecology, Govt. Medical College Kadapa. 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.

METHOD OF COLLECTION OF DATA: After the Ethical Committee approved, a prospective study was carried out. Social and maternal factors related to aetiology, clinical features, mode of management, maternal and fetal outcome, and preventive aspects were to be studied.

Table 1: Age distribution among the study population (High-risk pregnancy)

Table 2: Parity distribution among the study population

Table 3: Gestational Age distribution among the study population

Table 4: ANC Reg distribution among the study population

Table 5: Urban and Rural distribution among the study population

Table 6: Education distribution among study population

Table 7: Referred distribution among study population

Table 8: Fetal conditions distribution among study population

Table 9: Diagnosis distribution among study population

Table 10: Mode of delivery distribution among study population

Table 11: Fetal Outcome distribution among the study population

Table 12: ICU Admission distribution among study population

Figure 1: Reason for ICU Admission distribution among study population

Figure 2: Maternal outcome distribution among study population

Table 13: Maternal outcome distribution among the study population

Fetal Outcomes: 67% of cases resulted in live birth, 13% in abortion, 6% in intrauterine death (IUD), 6% in intrauterine growth restriction (IUGR), 2% in neonatal mortality, 4% in perinatal mortality, and 2% in congenital anomaly.

Maternal outcomes: 98% of the participants survived, while 2% did not. The interval between admission and death showed that 50% of the deaths occurred within 5 days and 50% of death occurred within 10days

There were 240 cases of obstetric emergency during the period. Thus, incidence came out to be 10.3%. Present study has 52% of patients as unbooked which is almost similar to the study done by Oladapo et al ⁽⁶⁾ (2005) and Siddique et al ⁽⁷⁾ (2012) Present study has 21 incidences of APH which is comparable at Prual et al ⁽⁸⁾ (2000). Present study has 3% cases of PPH which is comparable to Oladapo et al ⁽⁶⁾ (2005) and Siddique et al ⁽⁷⁾ (2012). HDP constituted 13% cases of obstetrical emergencies which is similar to the study done by Oladapo et al ⁽⁶⁾ (2005). Obstructed labor constituted 2.3% cases which is comparable to Oladapo et al ⁽⁶⁾ (2000). Most common cause of maternal mortality in present study was haemorrhage which is comparable to Prual et al ⁽⁸⁾ (2000). Present study shows HDP contribution to maternal mortality 13.64% which is almost similar to Siddique et al ⁽⁷⁾ (2012), Prual et al ⁽⁸⁾ (2000).

From the present study it is concluded that Obstetric emergencies are more common in subjects who are unbooked, belong to low socioeconomic status and have poor access to antenatal care. Distance of referral institute from hospital is directly proportional to the propensity of obstetric complications. Most of the maternal complications occur in the third trimester of pregnancy. Anemia has a major bearing on maternal morbidity and mortality. Hemorrhage, Hypertensive disorders of pregnancy, Puerperal sepsis, Rupture uterus, Inversion uterus, Cardiac failure due to severe Anaemia and Viral hepatitis are the major causes of maternal mortality. Most of the mortality occur in those cases who are unbooked and are referred from greater distance. Fetal morbidity and mortality is also high in cases who are unbooked and have no antenatal care. Thus, there is a direct need of proper antenatal care including treatment of anemia, timely referral from periphery of high-risk cases to prevent maternal and fetal morbidity and mortality.

Funding: No funding sources

Conflict of interest: None declared.

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