Profile of Pregnant Women who Underwent Cesarean Section and their Perinatal Outcome at a Tertiary Referral Hospital

Objective: To investigate the effectiveness of referral system, in regard to pregnant women with indication of C-section, and to learn the patients’ profile and their baby’s perinatal outcome. Methods: The research uses a retrospective descriptive method utilizing patient medical records with history of C-section at RSCM from January 2016 to December 2019. The target population is all pregnant women who were referred and performed cesarean section to at the hospital. Result: The most indications of C-section were premature membrane ruptures (16.1%), fetal distress (14.5%) and previous C-section (14.1%). There were 1585 cases (41.9%) coming without referral, 779 cases (20.6%) were bookcase, and 806 (21.3%) non-bookcase without referral. The main reasons for referral were absence of NICU facilities (27.31%), premature membranes rupture (20.81%), and eclampsia/ preeclampsia/HELLP syndrome (15.40%). Most babies are born with normal weight (2500-3999 grams) as many as 45.1% and 54.9% are groups of babies with abnormal weight. Most babies have an APGAR score 5 minute of 7-10 (83.6%). As many as 47.8% rooming in and infants requiring perinatological care in both SCN and NICU are 52.1%. Conclusions: The study found that the effectiveness of RSCM tiered referral system still has much room for improvements. The study also found gap between number of referred cases and the cases eventually underwent for C-section with the same indication. The screening can be done better for an indication of the origin of the reference whether it is appropriate to do the reference or not.