scholarly journals Prevalence of teenage pregnancy and its obstetric and perinatal outcomes in a rural tertiary care hospital

Author(s):  
Venkata Ramya Krishna Madala ◽  
Keshav Gangadharan ◽  
Pradeep Shivaraju ◽  
Devivaraprasad Mateti

Background: Teenage pregnancy has been reported as one of the leading causes of death in adolescent girls in both developed and developing countries. In developed countries teenage pregnancies are most common in unmarried girls whereas in developing countries like India where early marriages are more common, teenage pregnancies are seen mostly in married women.Methods: In this retrospective observational study, data between January 2018 and December 2019 was studied; data was evaluated using MS excel for statistical purpose. In the present study, only pregnant women less than 20 years were included.Results: Out of 6,028 pregnant women delivered during this period, 686 i.e. 11.3% age of women were less than 20 years, 609 (88.7%) had delivery at term and the remaining 77 (11.2%) women had preterm delivery. As per this study, incidence of hypertensive disorders were 12.24%, 5.5% were associated with anemia and most of them had vaginal delivery (65.01%) including induced and instrumental; cesarean section was 35.5%. In present study, 24.1% babies were of low birth weight and 3.49% of babies were intrauterine growth restricted (IUGR) babies.Conclusions: This study showed hypertensive disorders were the most common maternal complication and the incidence of vaginal delivery was higher compared to that of cesarean section, incidence of anaemia was less compared with other studies. Proper antenatal care, institutional delivery and postnatal care can reduce fetal and maternal complications in childbearing women in teenage age group. 

Author(s):  
Radha Kumari Paladugu ◽  
Srinivas Jagath Pentakota ◽  
Sushma N.

Background: Anaemia in pregnancy is now considered as a major public health problem, caused by iron deficiency. WHO has estimated that prevalence of anaemia in developed and developing countries in pregnant women is 14% in developed countries and 51 percent in developing countries and 65-75% in India. Various programmes regarding anaemia prophylaxis and maternal health have been implemented but still the prevalence of anaemia related complications among pregnant women continues to be high. Hence the present study was conducted to study the prevalence and pregnancy outcome as a result of anaemia in a tertiary care center in Visakhapatnam. Methods: A cross sectional descriptive study was carried out from June 2016 to August 2016 in the Department of Obstetrics and Gynecology among postnatal women in King George hospital, Visakhapatnam. A semi-structured questionnaire was prepared and information regarding age, socioeconomic status, parity, gestational age interval between pregnancies and outcome and complication of pregnancy were collected. Results: Mean age of study population is 22.4 years. Out of 100 women involved in the study 65 are from urban areas 29 from rural areas and 6 from tribal areas. Majority of the study population 66% were having HB% between 8-11% i.e. mild anaemia. When Outcome of pregnancy was seen in relation to anaemia majority of the women had live births (90%) followed by 7% IUDs and 2% still births. Conclusions: Majority of the women are in the age group of 20-24 years. Socioeconomic status is directly related to anaemic status of the women. Majority of the women had complication of puerperal sepsis. 


Author(s):  
Priti Kumari ◽  
Sipra Singh ◽  
Salma Khatun ◽  
. Shashikar

Background: Eclampsia is characterized by the sudden onset of generalized tonic clonic seizures. Eclampsia is usually preceded by a history of the pre-eclampsia but rarely arises in a woman with minimally increased blood pressure and no proteinuria. Eclampsia most commonly occurs in the third trimester, though rarely eclampsia may occur before 20 wks in molar or multiple pregnancy. The aim of the study was to compare maternal and fetal outcome in antepartum eclampsia when terminated by vaginal delivery and caesarean section.Methods: 50 women with eclampsia attending emergency department OBG department of Katihar Medical College, Katihar were collected from Feb 2015 to Sep 2016. Depending upon the mode of delivery, they were divided into two groups, CD group where caesarean section was performed and VD group where vaginal delivery was performed.Results: Of the 50 cases, caesarean section was done in 40% of the cases, while vaginal delivery was carried was carried in 60%.Maternal complications in CD group was 35% and 80% in VD group (p<0.001).The incidence of live births, still birth and neonatal death was 85%, 15%, 0% in CD group and 60%, 40%, 10% in VD group. The corrected perinatal mortality was 50%.Conclusions: Timely caesarean section reduces maternal and perinatal mortality and improves their outcome in antepartum eclampsia.


Author(s):  
Bilal Ur Rehman ◽  
Javid Ahmad ◽  
Rauf Ur Rashid Kaul ◽  
Mohammad Kaleem ul Haque

Background: Pregnancy is a major psychological, as well as physiological event; women may find themselves unable to cope with additional demands of pregnancy. Mental illness during pregnancy-whether anxiety, depression or more severe psychiatric disorders-can have a significant negative impact on a mother and her baby. Poor psychological health has been associated with low birth weight, premature birth, perinatal and infant death, postnatal depression, as well as long term behavioural and psychological impacts on the child. Depressive disorders are a common source of disability among women. Mental health problems during pregnancy and postpartum periods are one of the alarming health issue among women. Community-based epidemiological data on antenatal depression from developing countries is scarce. This study was conducted to assess the mental health status of pregnant women attending antenatal clinic of tertiary care hospital, SKIMS, Srinagar (J and K).Methods: A cross sectional study was conducted over a period of six months from 1stSeptember 2016 to 28th February 2017 among randomly selected pregnant women attending antenatal clinic of tertiary care hospital, SKIMS, Srinagar. A total of 200 pregnant women formed the study subjects. Data was collected by interviewing the pregnant women using pre-designed, pre-tested, semi-structured questionnaire. Data was analysed using Statistical Programme for the social science (SPSS) version 19.0.Results: Amongst the study population, prevalence of depressive disorder was 26%. The depression was significantly increasing with advancing pregnancy and advancing age. Socio-economic status and depression was associated statistically significant (p=0.024). Women with bad relationship with in laws had significantly more depression compared to those who had good relationship with in laws (P=0.0037). The association between parity and depressive disorder was statistically insignificant(P=0,7144).Conclusions: When we care for mother we care for two live and live without psychological consideration is completely materialistic. A depressive symptom occurs commonly during 2nd and 3rd trimester of pregnancy, drawing attention to a need to screen for depression during antenatal care. Maternal health policies, a priority in developing countries, must integrate maternal depression as a disorder of public health importance. Intervention should target women in the early antenatal period.


2021 ◽  
pp. 1-3
Author(s):  
Triza Kumar Lakshman ◽  
Ekta Chhabra ◽  
Ravindra S. Pukale

Introduction: Giving birth can be a long and painful process and is not always a perfect one. Instrumental vaginal delivery is an art and provides a 1 temporal advantage over cesarean delivery. It is also an alternative procedure for delivery in emergency obstetrics. Instrumental vaginal delivery is an integral part of Obstetrics care world wide. The present study was carried out to evaluate the maternal and neonatal outcome in operative/assisted vaginal delivery. Method: We performed a retrospective observational study of women with singleton term pregnancies who underwent operative vaginal delivery at Adichunchanagiri Institute of Medical Sciences. The study was conducted between August 2019 to August 2020 for the duration of 1 year and the data was accrued from patient database retrospectively and was entered in Microsoft Excel (Version 16.4) for Windows. Results: During the study period, 95 patients underwent Instrumental Vaginal Delivery, of which 74 were vacuum assisted and 21 were forceps nd delivery. The most common indication for Operative vaginal delivery was failure of maternal efforts followed by prolong 2 stage of labour in vacuum group and severe pre-eclampsia in forceps group. Vacuum was used more often than forceps for most of the deliveries. Maternal st nd complication like 1 and 2 degree perineal tear were seen more often with the use of forceps. Instrument marks and bruising were found in the neonates delivered by forceps and a greater incidence of cephalohaematomas and caput in the neonates delivered with vacuum. Conclusion: A successful instrumental vaginal delivery can be achieved with lesser maternal and neonatal morbidity with timely assessment of labour and skilled operator. The overall rate of perinatal and maternal morbidity and mortality vary by indication and operative instrument. Women who underwent forceps-assisted delivery had greater rates of maternal complications than those who underwent vacuum-assisted delivery


2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Tulasa Basnet ◽  
Baburam Dixit Thapa ◽  
Dipti Das ◽  
Ramesh Shrestha ◽  
Sarita Sitaula ◽  
...  

Background. Breech presentation is associated with increased rates of maternal and perinatal morbidity regardless of mode of delivery. After the results of Term Breech Trial, most of the countries adopted the protocol of cesarean section for term breech delivery because of which breech vaginal delivery is becoming rare. The aim of this study is to evaluate short-term maternal and perinatal outcomes of breech vaginal delivery at a tertiary care hospital in Nepal. Methods. A retrospective review of case records of all women who had vaginal breech delivery from April 13, 2016, to April 12, 2018, was conducted, over a period of two years. Available demographic variables, obstetric characteristics, details of labor, postpartum complications, and perinatal complications were recorded and analyzed. Results. Out of 21,768 cases of deliveries during the study period, the incidence of term breech deliveries was 528 (2.4%) among which the mode of only 84 (17.8%) deliveries was vaginal. Most of the deliveries were unplanned and were conducted because emergency cesarean section could not be performed. Three (3.6%) women had postpartum hemorrhage, and four (4.8%) had entrapment of aftercoming head, two of them requiring Dührssen incisions. Adverse perinatal outcomes were seen in 23.8% of such deliveries with <7 APGAR score at 5 minutes in 20.2%, neonatal admission in 17.7%, and perinatal mortality in 8.3%. The perinatal mortality was significantly associated with birthweight less than 2500 grams as compared to birthweight ≥2500 grams (21.1% versus 4.6%; P = 0.043 ). Conclusion. The perinatal outcomes for vaginal breech delivery are grave with our existing health facilities, especially when the deliveries are not well planned.


2016 ◽  
Vol 12 (2) ◽  
pp. 22-26
Author(s):  
Aftabun Nahar ◽  
Rifat Sultana ◽  
Fatema Mahbooba Akter ◽  
Munira Ferdausi ◽  
Md Abdullah Yusuf ◽  
...  

Background: Use of misoprostol in term pregnancy is very useful for the better outcome during delivery. Objective: The purpose of the present study was to see the delivery outcome among the term pregnant women. Methodology: This cohort study was carried out in the Department of Obstetrics and Gynaecology at Sir Salimullah Medical College and Mitford Hospital during the period from 1 st September 2005 to 28th February 2006. Primi or second gravida patients with the gestational age between 37 weeks to 42 weeks in singleton pregnancy with cephalic presentation and not in labour who came for delivery purposes during the study period at any age were selected as study population. After proper selection of the cases, induction of labour (IOL) was done by applying Tab Misoprostol 50mcg in the posterior vaginal fornix. Purpose of induction of labour was successful when vaginal delivery occurred without any untoward side effects and without any surgical interference. Result: Out of 60 pregnant women 21 (35%) patients had unfavourable Bishops' score with 3-5 and 39 (65%) patients had favorable Bishops' score with 6-10. 39 patients had favourable pre- induction cervical score, among them 79% had delivered vaginally and 21% had undergone LUCS. 21 patients had unfavourable cervix, among them 57% experienced vaginal delivery and 43% experienced LUCS. Out of all study population 60% of study population who were primigravide had vaginal delivery in 67% cases and caesarean section in 33% cases and among 40% 2nd gravida cases vaginal delivery was 79% and caesarean delivery was 21%. Conclusion: In conclusion the use of misoprostol during term pregnancy is significantly related with the normal delivery.Journal of Science Foundation 2014;12(2):22-26DOI:  http://dx.doi.org/10.3329/jsf.v12i2.27733


Author(s):  
Gayathrie Devi ◽  
Kayalvizhi . ◽  
Poovathi M.

Background: The objective is to study the fetomaternal outcome in teenage pregnancy at MGMGH for the study period of 6 months from April 2018 to September 2018. Teenage pregnancy is a worldwide health problem. WHO defined adolescence as the period from 10-19 years. It is a serious health problem in a developing country like India. Teenage pregnancy is associated with high risk of prematurity, low birthweight, preeclampsia and anaemia. The NHFS IV 2015 -2016 estimates that overall teenage pregnancy in India 7.9%.Methods: It is a retrospective study conducted in a tertiary care hospital at MGMGH, Trichy over a period of 6 months.251 teenage pregnant women delivered at our institution were selected for the study out of 4508 total deliveries during the study period. Parameters including incidence, age, parity, booking status, educational and socioeconomic status, medical disorders, antepartum, intrapartum, postpartum complications, mode of delivery and neonatal outcome were studied.Results: Study showed the incidence of teenage pregnancy at our MGMGH is 5.56%. Among these teenage pregnant women 47.1% had anaemia, 23.1% had gestational hypertension,4.8% of women had eclampsia, 22.3% % had preterm delivery. Lscs rate was 27.1%,70.29 % had Normal vaginal delivery,1.6% had instrumental deliveries, 31.5% had low birth weight babies,28.2 % NICU admissions, 2.9% perinatal deaths.Conclusions: Teenage pregnancy is associated with increased incidence of anaemia, pre-eclampsia, eclampsia, preterm delivery, instrumental delivery, low birth weight and perinatal death. By improving socio economic status, education, nutrition, good antenatal care, public awareness, institutional delivery and postnatal care help in reducing maternal and perinatal morbidity and mortality in adolescent pregnancy.


2015 ◽  
Vol 11 (4) ◽  
pp. 349-354 ◽  
Author(s):  
S Panda ◽  
V Jha ◽  
AS Singh

Mother requesting of caesarean reflects a belief among society that elective caesarean safer than vaginal delivery in term of fetus and mother. Although the study data neglecting the facts other skewed part in this issue is consideration of resources, as in developing countries, where maternal mortality is still high due to lack of adequate resources. Mother coming to obstetrician with mother’s request should individualize in every case considering mother’s argument, society and evidence base guideline.Kathmandu Univ Med J 2013; 11(4): 349-354


Author(s):  
Shetal Prajapati ◽  
Sakina Johar

Background: The importance of amniotic fluid volume as an indicator of fetal wellbeing has made its assessment an important part of antenatal fetal surveillance. Oligohydramnios complicates 0.5% to 8% of pregnancies and the prognosis for pregnancies complicated by oligohydramnios is dependent on the gestational age and the underlying aetiology. This study aims to determine the feto-maternal outcome of oligohydramnios in a tertiary care hospital.Methods: In this study, we included 100 patients of oligohydramnios, with AFI ≤5 cm with a singleton pregnancy with intact membranes. The maternal outcome was accessed by mode of delivery and maternal complications and the neonatal outcome was studied by birth weight, APGAR score, NICU admission and perinatal mortality.Results: PIH was the most common risk factor in 38% of cases followed by IUGR in 29%, doppler changes in 24%. The reduced diastolic flow was the most common abnormal doppler finding in the 23% abnormal doppler cases, from which 39% underwent cesarean section, 9% required NICU admission and 61% had neonatal death. 53% delivered by cesarean section of which 13% had neonatal death. NICU admission is required in 64% of cases.Conclusions: We conclude that oligohydramnios is a high-risk pregnancy and proper antepartum care, intensive fetal surveillance and intrapartum care are required in a patient with oligohydramnios. Every case of oligohydramnios needs careful antenatal evaluation, parental counselling, individualization, decisions regarding time and mode of delivery. Continuous intrapartum fetal monitoring and good neonatal care are necessary for a better perinatal outcome.


2019 ◽  
Vol 57 (218) ◽  
Author(s):  
Shanti Sunuwar Subedi ◽  
Sajjan Sharma ◽  
Munjal Yadav

Introduction: WHO defines adolescent pregnancy as any pregnancy from a girl who is 10-19 years of age, the age being defined as her age at the time the baby is born. Globally, adolescent birth rate is 44 per 1000 women aged 15-19 years whereas 33 per 1000 in South East Asian region. The main objective of the study is to find the prevalence of adolescent pregnancy in a tertiary care hospital. Methods: A descriptive cross-sectional study was conducted in Department of Obstetrics and Gynecology, Nobel Medical College and Teaching Hospital, Biratnagar over a period of six months from 1st January 2018 to 30th June 2018. Using the convenient sampling technique, 2688 samples were studied and the descriptive statistical analysis was done. Results: The prevalence of teenage pregnancy was found to be among 143 (5.3%) [5.3%±0.85% at 95% Confidence Interval]. Maximum adolescents of 95 (66.4%) presented at gestational age between 37 to 40 weeks. Regarding contraception, only 2 (1.4%) of teenage mothers had used Injectable Depo Provera. Conclusions: Adolescent pregnancy in developed countries is usually outside of marriage and carries a social stigma but in the context of developing countries it usually happens within marriage and half of them are planned reflecting educational status and contraception knowledge. Effective interventions need to be developed like strict enforcement of laws prohibiting teenage marriage.


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