ABSTRACT
Aims: To identify the possible effects of hypertensive disorders of pregnancy (HDP) on maternal health outcomes of women attended primary health care centers (PHCCs) in Gaza Strip –Palestine.Study Design:A cross-sectional comparative design.Place and Duration of Study:The study was conducted at 6 PHCCs from August 2016 to May 2017.Methodology:Two groups of 215 hypertensive mothers and 215 normotensive mothers in the last pregnancy were recruited by 3-stage stratified random sampling technique. A detailed questionnaire filled through face to face interviews in addition to medical records revision in 2017. Pearson's Chi-square and t-tests were used to compare the outcomes between the two groups.Results:HDP in 215 women were classified as pregnancy-induced hypertension (n = 153, 71.2%) and chronic hypertension (n = 62, 27.8%). The mean age of HDP women was 28.8 ± 6.8 years. About 40.9% live in refugee camps; 23.7% had gravida ≥ 7; 54.6% had BMI > 30 and 21.9% had a history of twice or more abortions. Only 20% of HDP women received preconception care. Cesarean section and assisted delivery were significantly higher among hypertensive mothers (37.2% and 26.9%) compared with non-hypertensive (16.3% and 8.4%) respectively (P= 0.001). Incidence of preeclampsia/eclampsia, antepartum hemorrhage and postpartum hemorrhage, were significantly higher among HDP women (29.3%, P= 0.001; 14%, p=0.001; 7%, P= 0.003 respectively) while no significant differences in abrupio placenta (0.9%; P= 0.25), placenta previa (0.5%, P= 0.75) HELLP syndrome (0.9%, P= 0.24) were found between the two groups. 20.9% mothers with pregnancy-induced hypertension were not recovered and developed chronic hypertension.Conclusion:Women with HDP are at higher risk to have adverse maternal outcomes compared to normotensive women in GS. Preconception care, early diagnosis and prenatal follow-up would improve maternal and fetal prognosis
ABSTRACT
Introduction: Early marriages and teenage pregnancies are important contributing factors for high maternal as well as neo-natal morbidity and mortality. Objectives: To assess the magnitude of obstetric profile of teenage and non-teenage primi mothers and to determine the association among them. Methodology: A cross-sectional study was conducted at OB/Gynac clinic Krishna hospital Karad over a period of first quarter of year 2012. 93 eligible teenage primi mothers and equal number of non-teenage primi mothers admitted to Krishna hospital for delivery were enrolled, interviewed and observed for socio-demographic, obstetric outcome and it’s complications by investigator according to pre- designed structured proforma. Frequency percentage distribution and association was determined by applying tests of significance. Observations: Magnitude of teenage primi pregnancy was 6% during study period and most of them 92.50%, 76.30% and 46.20% were Hindus, housewives and belonged to lower class by religion, occupation and economically with mean age at marriage and delivery was 17.8 yrs and 18.8 yrs respectively. Max. 81.7% teenage primi mothers were anaemic and the percentage of obstetric complications like PIH, Oligohydramnios, PROM, Foetal distress among teenage primi mothers was 24%,8.6%, 1%, and 6.4% which was higher than nonteenage mothers. IUGR, cord prolapse, breech presentation and abruption placenta also reported among teenage primi mothers, however absent among non-teenage mothers. Max 55.9% teenage mothers were delivered before expected date of delivery and proportion of low birth weight baby was also high (39.8%) in teenage mothers than non-teenage mothers. Chance of delivery of male baby also increases as age at marriage increases. Conclusion: Adolescent pregnancy is an issue that calls for more education & support to encourage girls to delay motherhood until they are ready.