Profile of patients and referrals at a midwife obstetric unit in Tshwane North subdistrict, Gauteng province

Abstract

Midwife obstetric units (MOUs) are primary health level facilities at which antenatal care and delivery for low-risk patients are performed. They are important facilities because they are at the interface of the health system in South Africa and the population. One of their main functions is the identifcation and referral of high-risk patients. However, few recent published studies describe the profle of patients utilising the services of MOUs and their referral data in detail in South Africa. The study design was a cohort study. Three hundred and nineteen patients reporting their pregnancies at the MOU were enrolled in the study, and were monitored for the duration of their pregnancies. 20.1% of the women were classifed as high risk at booking. Additionally, 18.2% were referred in labour. Of the high-risk patients, 21.2% of them delivered at the MOU. These women should have delivered at hospital and therefore presented a considerable risk for the MOU. 3.4% of women in the study delivered at home. This constitutes a signifcant risk for these women. Finally, the data showed the detailed distribution of risk factors, taken from history and examination, as well as important delivery information on the study patients. For example, 6.2% of the women had had a Caesarean section for a previous pregnancy, 2.8% had had pregnancy-induced hypertension, 1.5% tested positive for syphilis during their current pregnancy, and 1.8% developed severe anaemia.