Background: Maternal and neonatal complications remain major contributors to morbidity and mortality in developing countries, especially among women referred to tertiary care centres with high-risk pregnancies or obstetric emergencies. Evaluating the outcomes of referred obstetric cases is essential for identifying gaps in antenatal care and referral services.

Objectives: To assess maternal and neonatal outcomes among referred obstetric patients and to analyse factors associated with adverse fetomaternal outcomes.

Methods: This prospective observational study was conducted in the Department of Obstetrics and Gynaecology of a tertiary care teaching hospital in Jaipur, India, from July 2024 to December 2025. A total of 96 referred obstetric women with gestational age ≥ 24 weeks were included. Sociodemographic details, referral characteristics, obstetric complications, maternal outcomes, and neonatal outcomes were recorded using a structured proforma and analysed using descriptive and inferential statistics.

Results: The mean age of participants was 28.7 ± 3.5 years. Most women were from rural areas (59.4%) and were referred at term (72.9%). Previous lower segment caesarean section, anaemia, hypertensive disorders, and premature rupture of membranes were common indications for referral. Caesarean delivery was performed in 60.4% of cases. Blood transfusion was required in 31.3% of women, and 14.6% required ICU admission. Live birth occurred in 90.6% of pregnancies, while stillbirths accounted for 5.2%. Most neonates had a 5-minute APGAR score >7 (58.6%). NICU admission was common, with birth asphyxia being the leading indication.

Conclusion: The findings indicate that referred obstetric cases carry a high risk for both maternal and neonatal complications, largely influenced by avoidable factors such as delayed referral and insufficient antenatal care. Strengthening peripheral healthcare services, improving early risk identification, and ensuring timely referral and transport are crucial for reducing preventable fetomaternal complications.

KEYWORDS: Referred Obstetric Cases, Fetomaternal Outcomes, Maternal Morbidity, Neonatal Outcomes, High-risk Pregnancy.