INTEGRATED CLINICAL SPECTRUM OF MATERNAL AND PEDIATRIC MORBIDITY, PLASTIC SURGICAL INTERVENTIONS, MEDICO-LEGAL PRESENTATIONS, AND DRUG UTILIZATION PATTERNS IN A TERTIARY CARE HOSPITAL

Abstract

Background: Tertiary care hospitals in developing healthcare systems manage a wide spectrum of clinical conditions that extend beyond routine maternal and pediatric care, including plastic surgical interventions, medico-legal presentations, and complex pharmacotherapeutic practices. However, integrated data evaluating these multidisciplinary clinical patterns remain limited, particularly in resource-constrained settings.

Objective: To evaluate the clinical spectrum of maternal and pediatric morbidity, plastic surgical interventions, medico-legal presentations, and drug utilization patterns in a tertiary care hospital.

Methods: This cross-sectional study was conducted in a tertiary care teaching hospital from January 2025 to December 2025. Patients presenting to the departments of obstetrics and gynecology, pediatrics, plastic surgery, emergency medicine, and medico-legal services were included through non-probability consecutive sampling. Demographic variables, clinical diagnoses, surgical interventions, medico-legal characteristics, and prescribing patterns were recorded using a structured data collection proforma. Drug utilization patterns were assessed according to the World Health Organization prescribing indicators. Statistical analysis was performed using SPSS version 26.0. Descriptive statistics were used to summarize frequencies, percentages, means, and standard deviations. Associations between categorical variables were analyzed using the chi-square test, with p <0.05 considered statistically significant.

Results: A total of 620 participants were enrolled in the study. Maternal morbidity accounted for 34.5% of cases, with hypertensive disorders of pregnancy and anemia being the most common presentations. Pediatric morbidity represented 31.8% of cases, predominantly involving respiratory tract infections, acute gastroenteritis, and febrile illnesses. Plastic surgical interventions comprised 14.2% of admissions, mainly related to burn injuries, traumatic soft tissue defects, and post-surgical wound reconstruction. Medico-legal presentations constituted 11.6% of cases, including road traffic accidents, physical assault, and poisoning events. Polypharmacy was observed in 39.4% of patients, while antibiotics were prescribed in 61.2% of encounters. Significant associations were identified between prolonged hospital stay and increased drug utilization burden (p=0.01).

Conclusion: The study demonstrates the diverse and interconnected clinical burden encountered in tertiary healthcare institutions, emphasizing the need for multidisciplinary coordination, rational pharmacotherapy, and integrated patient management strategies. Strengthening clinical surveillance systems and evidence-based prescribing practices may improve patient outcomes and healthcare efficiency in tertiary care settings.