Outcomes of Referral System for High-Risk Pregnant Women Receiving Services at the Delivery Room Unit, Srinagarind Hospital

Abstract

Background and Objectives: High-risk pregnancy could risk a threat to the illness and death of both the mother and the fetus. This study aims to examine the outcomes of referrals for high-risk pregnant womens receiving services at the delivery room unit of Srinagarind Hospital.

Methods: This retrospective descriptive study collected data from medical records, delivery reports, and the information system of Srinagarind Hospital. The sample consisted of pregnant women referred from four hospitals in the northern zone and other hospitals that exceeded their capacity to provide care. These referrals were made to the delivery unit between November 1, 2024, and January 31, 2025.The data collection was conducted in 5 parts: 1) general information of pregnant women, 2) pregnancy and childbirth history, 3) use of referral guidelines, 4) data on birth results, and 5) problems, obstacles, and suggestions. The data were analyzed using frequency distribution, percentages, averages, and descriptive narrative analysis.

Results: The study included 75 cases, comprising 68 deliveries, 6 discharges, and 1 referral for social security benefits. Among them, 56.00% had a previous pregnancy, and 65.33% experienced pregnancy complications. The main indications for referral were preeclampsia, uncertainty regarding fetal safety, multiple pregnancies, placental abnormalities, and newborns requiring advanced life support. The average gestational age at delivery was 37 weeks or more, 60.30%,  with 50.00% of cases resulting in cesarean section. Blood loss after delivery was less than 500 ml, 76.47% and 58.82% of women did not deliver as initially planned. A total of 74 newborns were delivered, including six sets of twins. Among them, 73 were born alive, while one was stillbirth before hospital arrival. Birth weight between 1,001-2,500 grams, 40.54 %. Additionally, 31.08% of newborns required resuscitation, and 44.60% were transferred to the normal postpartum ward.

Conclusion: The referral system for high-risk pregnancies has streamlined coordination, enabling faster access to medical care. This has contributed to safer deliveries for both mothers and newborns.