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Utilization of Phyo Referral Score in assessing maternal referral quality in emergency cesarean section of maternal COVID-19 cases in Pekanbaru, Indonesia

  • Ilham Sejahtera Lubis ,
  • Eugenius Phyowai Ganap ,


Link of Video Abstract:


Introduction: During the Coronavirus disease 2019 (COVID-19) pandemic, basic and emergency obstetric healthcare was hampered due to health service protocol changes. The reduced coverage of antenatal service during the COVID-19 pandemic increased the number of undetected high-risk pregnancies and the likelihood of obstetric emergency cases. This study assessed maternal referral quality using the Phyo Referral Score (PRS) on emergency cesarean section (ECS) patients infected by SARS-CoV-2.

Methods: This retrospective cohort study used secondary data originating from patient medical records who went through ECS from 1 January 2021 to 31 December 2021. The subject was chosen purposively by the inclusion criteria. A Total of 609 mothers went through Cesarean Section in 2021, there were 52 mothers who met the criteria. The data were described by frequencies, percentages, and mean ± standard deviation. The data was analyzed by Levene’s test and Chi-square test using IBM SPSS version 26.0.

Results: During the retrospective year, a total of 609 mothers went through Cesarean Section in 2021, there were 52 mothers who met the criteria. The most common indications of ECS were persistent fetal hypoxia (50.0%), placenta previa (13.5%), and maternal respiratory failure (13.5%). Most of the patients had good referral quality. From the parameters of PRS, patients are more likely to have good referral quality if accompanied by medical staff, receiving stabilization procedures, and communicating with the hospital by phone before being referred, and transported by ambulance within the same cities.

Conclusion: Accessibility is a critical component of obstetric emergency cases. Even during the COVID-19 pandemic, ensuring that mothers have a good referral quality to access advanced obstetrical care can help the survival of both mothers and fetuses.


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How to Cite

Lubis, I. S., & Ganap, E. P. (2023). Utilization of Phyo Referral Score in assessing maternal referral quality in emergency cesarean section of maternal COVID-19 cases in Pekanbaru, Indonesia. Bali Medical Journal, 12(3), 3129–3134.




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Ilham Sejahtera Lubis
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