ASSESSMENT OF PREGNANCY OUTCOME IN PRIMIGRAVIDA: COMPARISON BETWEEN BOOKED AND UN-BOOKED PATIENTS
Abstract
Background: Primigravida (PG), defined as a woman who conceives for the first time, is in a high-riskgroup. Objective of this study was to evaluate the pregnancy outcome in booked and un-bookedprimigravida. Methods: This was a hospital based comparative study conducted in Women andChildren Hospital Abbottabad from May 1998 to November 1999. A total of 322 patients wereincluded in the study. Inclusion criteria was all primigravida, both booked as well as un-bookedpatients. Evaluation was done by taking detailed history, clinical examination and relevantinvestigations. Antenatal, intrapartum and postnatal complications were noted in the mothers. Perinatalmorbidity and mortality was assessed in both the groups. Results: Out of 322 cases, 52 patients werebooked and 270 patients were un-booked. Majority of un-booked patients belonged to the rural areasand were from lower socioeconomic group, between the age group of 15–35 years. The rate ofinstrumental deliveries was high (87.5%) in un-booked patients as compared to booked patients(12.5%). Caesarean section rate in un-booked patients was higher (76.5%) as compared to bookedpatients (23.5%). Twenty-three (20%) patients of un-booked group presented in emergency mainlywith obstructed labour. Twenty-two (19.8%) patients had pregnancy induced hypertension, whilefoetuses of 48 (43.2%) patients developed foetal distress. Antipartum haemorrhage was present in 12(10.8%) patients, while prolonged labour with foetal distress was noted in 26 (23.4%) patients in unbooked group. Postpartum haemorrhage and puerperal pyrexia was more common in un-bookedpatients (7.7% and 18.6% respectively). Perinatal mortality was high in un-booked patients (19.5%) ascompared to booked patients. Conclusion: Primigravida are high-risk patients. Comprehensiveantenatal care should be provided in this group of patients to have better maternal and foetal outcome.Keywords: Primigravida, Pregnancy, Outcome, Complications, Women, Antenatal, Maternal, foetalReferences
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