RESUMO
To evaluate the effect of maternal anemia on perinatal outcome. Cohort study Department of Obstetrics and Gynecology, Liaquat University Hospital Sindh Pakistan from March 2007 to December 2007. A total number of 1012 women were delivered during the study period. All singleton pregnant women who attended the out patient department before 18 weeks of gestation were included while women with multiple pregnancies, past history of preterm delivery and medical illness except anemia were excluded from the study. Relative risk and a 95% confidence interval were calculated through. Demographic and socioeconomic features of both groups were compared by Chi-Squared test using SPSS 17. A p-value of or less than 0.05 was considered as significant. A total of 818 women fulfilled the inclusion criteria, 407 in anemia group and 411 in non-anemic group. Hemoglobin range of anemic group was from 5 to 10 gram/dl. While in non anemic group hemoglobin ranges from 11 to 13gram/dl [mean11.87 +/- 0.54]. Risk of premature birth and low birth weight among anemic women was 3.92 and 2.2 times more than nonanemic women, which was statistically significant. Risk of IUGR was 2.2 times greater in anemia than non-anemic group. However this was statistically significant. Our study shows that risk of preterm delivery and low birth weight were greater in anemic group than non anemic group, which was statistically significant. Preconceptional evaluation along with planned pregnancy is important in decreasing the frequency of maternal anemia and its effect on fetus and newborn
RESUMO
To determine the frequency of factors responsible for apparently high cesarean section rate in teaching hospital, Liaquat university hospital Hyderabad and to assess maternal morbidity and fetal out come after cesarean section. Descriptive study. In obstetric and gynecology Department of Liaquat university hospital Hyderabad Sindh Pakistan from 3 rd January 2007 to 2 nd January 2008. Total 1666 deliveries were conducted in year 2007 to 2008. Out of these 584 were delivered by cesarean section and 1082 were delivered by normal vaginal delivery. Clinical record of all the patients who underwent Cesarean section was analyzed. All the patients who underwent cesarean section were included in this study while clinically diagnosed cases of ruptured uterus and proved on lapratomy were excluded from this study. A proforma of each patient was completed, regarding the relevant information of cesarean delivery and fetal outcome. Cesarean section was done on 584 [35%] patients while normal vaginal delivery was conducted on 1082 [65%] patients. A total of 149 [25.5%] patients' underwent elective cesarean section while in 435 [74.4%] patient's cesarean section was done in emergency. A total of 144 [24.7%] patients were booked while 440 [75.3%] patient's were unbooked. Most common indication of cesarean section was repeat cesarean section, which was seen in 182 [31.2%] patients. Among obstetric complications major problem encountered was massive hemorrhage, which is seen in 64 [11%] patients wounds sepsis was second most common complications. A total of 453 [77.6%] newborns were born alive and 50 [8.6%] neonates were dead which included fresh and macerated still birth. 81 [13.8%] neonates died later on in pediatric unit [END]. The rate of cesarean section in our study was 35%, which is quite high. Commonest indication of cesarean section observed in this study was previous cesarean section. Majority of patient's who underwent cesarean section were unbooked. Commonest obstetric complication was massive hemorrhage followed by wound sepsis. Perinatal mortality was also high in this study