Skip to main content

Table 2 Indications for referral

From: The third delay: understanding waiting time for obstetric referrals at a large regional hospital in Ghana

Indication Number Percent (%)
Fetal-pelvic size disproportiona 346 24.3
Hypertensive disorders of pregnancyb 139 9.8
Prior uterine scarc 129 9.1
Maternal miscellaneousd 115 8.1
Anemiae 103 7.2
Self-referral/Ridge Hospital patient 92 6.5
Fetal compromisef 69 4.8
Fetal malpresentationg 62 4.4
Rupture of membranesh 54 3.8
Labour 45 3.2
Lack of resources at referral sitei 43 3.0
Infectious causesj 39 2.7
Acute haemorrhagek 39 2.7
Prematurityl 29 2.0
Previous poor obstetric outcomem 27 1.9
Multiple gestationn 26 1.8
Record illegible 22 1.5
Maternal age extremes (≤15 or >35 yr) 18 1.3
Intra-uterine fetal demise 14 1.0
No/poor prenatal care 12 0.8
Fetal miscellaneouso 2 0.1
Total 1425 100%
One referral indication 739 68.3%
Two referral indications 315 29.1%
Three referral indications 28 2.6%
  1. There were 1082 referral records captured for deliveries occurring at Ridge Regional Hospital from September 9, 2012 to November 11, 2012
  2. aCephalopelvic disproportion, fetal macrosomia, large maternal abdomen, post-term pregnancy, over 40 weeks estimated gestational age, borderline pelvis, contracted pelvis, failure to progress (delayed or prolonged labour, arrest of labour, slow progress, failed induction, unfavorable cervix, high head in labour, obstructed labour)
  3. bChronic hypertension, PIH, pre-eclampsia, severe pre-eclampsia, or eclampsia
  4. cPrevious cesarean delivery, prior myomectomy, or previous uterine rupture
  5. dMaternal asthma, diabetes, gestational diabetes, prior abdominal surgery, uterine fibroids, vaginal/vulvar growth or discharge, proteinuria, urinary tract infection, fever, generalized edema, short/long pregnancy interval, short maternal stature, maternal distress, sterilization request, grand multiparty, seizure disorder, mental illness, obesity, patient refusal for care, patient lacks labouratory or scan information, crippled, rhesus negative
  6. eMaternal anemia or sickle cell disease
  7. fAbnormal cardiotocography, fetal tachycardia, fetal distress, oligohydramnios, meconium stained amniotic fluid, decreased fetal movement, intrauterine growth restricition, umbilical cord prolapse
  8. gFace/mentoposterior, brow, breech/footling breech, oblique, transverse, unstable lie, arm prolapse, leading twin breech, compound presentation
  9. hRupture of membranes, prolonged rupture of membranes, loosing liquor, gestations >37 weeks
  10. iNo electricity, no bed, no gloves, no water, no doctor, no anesthetist
  11. jHepatitis B, malaria, syphilis, human immunodeficiency virus
  12. kPlacenta previa, placental abruption, placenta accreta, ante-, intra- and postpartum bleeding, unclassified haemorrhage
  13. lGestation <37 weeks, prematurity, preterm labour or preterm premature rupture of membranes
  14. mBad obstetric history, prior stillbirth, prior ectopic pregnancy, unexplained history of intrauterine fetal death, previous failure to progress, prior cervical cerclage, previous peripartum haemorrhage
  15. nTwin pregnancy, triplet pregnancy
  16. oAnencephaly, severe hydrocephalus, polyhydramnios, fetal deformity