Obstetric Morbidity Associated With Utilization and Non-Utilization of Prenatal Care

Sumbala Ameen, Maria Sultan, Ammara Faisal

Abstract


Objective: This study was conducted to determine maternal morbidity associated with utilization and non utilization of prenatal care among pregnant ladies.

Study design and Duration: It is a case control type of study. This study was started in January 2017 and completed in December 2017 comprising on 12 months of duration.

Setting: This study was conducted in gynaecology and obstetrics ward of Shifa International Hospital Islamabad Pakistan.

Patients and Methods: In this study 230 cases were studied. These were pregnant ladies in different gestational ages. These females were divided into two groups. All the females who were taking proper prenatal care were kept in group-A (booked) and those not taking prenatal care were kept in Group-B (non-booked). There were 120 females in group-A and 110 in group-B. Morbidity associated with pregnancy was studied in both groups and was compared with each other. These females were reported in OPD and they were used to call for regular follow-up and any they were examined for any pregnancy related morbidity or complications. These females were admitted in the ward for delivery 4-7 days prior to expected date of delivery. Necessary investigations were carried out in cased of any emergency for cesarean section and anesthesia fitness was also taken for all patients in the study group. A proforma was designed to list pregnancy related complications of each case in the study group such as pre-eclempsia, eclempsia, hemorrhage, abortion and preterm, full term or post term birth. Any complication occurring intra partum or post partum was also recorded. Consent was taken from all the cases and also from the in charge of the ward for conducting study. All data was analyzed using Microsoft office and SPSS version 2007. Results were calculated in the form of frequencies and expressed via tables and graphs.

Results: There were ttal 230 cases in this study, 120 cases in group-A (booked group) and 110 were in group-B (non-booked). These females were in different ages. In booked group ages of females were 15-25 years in 30 cases, 80 females between age26-35 years and 10 females were above 35 years of age. In non-booked group 17 females were between 15-25 years, 75 were between 26-35 years and 18 were above 35 years of age. In booked group 38 females were primary gravid, 42 were having 1-2 children, 23 were having 3-4 children and 17 females had more than 4 children. Similarly in non booked group 39 females were primary gravid, 34 had 1-2 children, 25 females had 3-4 children and 12 females had more than 4 children. Mode of admission was via OPD in 70 cases and via emergency in 50 cases in booked group and 20 via OPD and 90 via emergency department in non booked group. In booked group 16 females gave birth to child in gestational age less than 38 weeks, 74 females had gestational age 38-40 weeks, 21 with gestational age 41-42 weeks and 9 cases with gestational age more than 42 weeks. In non booked group 30 females had gestational age less than 38 weeks, 49 had G.A 38-40 weeks, 20 females with G.A 41-42 weeks and 10 females had gestational age more than 42 weeks.

Conclusion: Proper use of prenatal care is associated with less morbidity and relatively safe delivery with minimum complications while non-utilization of prenatal care is associated with increased morbidity and mortality associated with pregnancy and poor maternal and fetal outcome. Health education in mothers and regular follow-up in pregnancy leads to healthy mother and child with full term birth.


Keywords


Perinatal morbidity, Maternal outcome, fetal outcome, prenatal care, maternal mortality

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