Background: Placenta praevia accounts for significant maternal morbidity and perinatal morbidity and mortality. Despite advances in blood transfusion technique and surgical procedure, abnormal placentation still remai...Background: Placenta praevia accounts for significant maternal morbidity and perinatal morbidity and mortality. Despite advances in blood transfusion technique and surgical procedure, abnormal placentation still remains a difficult challenge for obstetricians. Objective: To determine the influence of booking status on the fetal and maternal outcome among parturients with placenta praevia that underwent caesarian delivery. Methodology: This was a comparative and retrospective study between booked and unbooked subjects with significant placenta praevia that were delivered by caesarian section between January 1<sup>st</sup> 2004 and December 31<sup>st</sup> 2008 with respect to maternal and fetal outcome. Result: Out of 14,344 deliveries during study period, 123 cases of placenta praevia that underwent caesarian delivery were identified giving a prevalence rate of 0.86%. 49 subjects were booked while 74 were unbooked. There was no statistically significant difference between booked and unbooked cases with respect to risk factors (30.6% of booked and 23% of unbooked), X<sup>2</sup>(4) = 7.203, P = 0.126 and the mean blood loss at surgery (870.4 ± 486.9 ml in booked versus 779.7 ± 380.96 ml in unbooked), X<sup>2</sup>(1) = 0.202, P = 0.653. However, antepartum transfusion (12.2% booked versus 34.7% unbooked) and postpartum transfusion (51% booked versus 72% unbooked) showed statistically significant difference, X<sup>2</sup>(1) = 9.744, P = 0.002. One maternal death occurred amongst the unbooked cases and none among the booked cases. Statistically significant differences were also noted in the apgar score at 1 minute X<sup>2</sup>(3) = 15.528, P = 0.001 and 5 minutes X<sup>2</sup>(3) = 12.912, P = 0.005 respectively. More babies died in the unbooked group (19) compared to two (2) in the booked mothers. Conclusion: Unbooked status in placenta previa significantly increases the risk for antepartum and postpartum transfusion, is associated with higher mortality, increased preterm delivery, poorer apgar scores and higher perinatal mortality rate.展开更多
Background: Inadequate antenatal care, both in coverage and standard, has been linked with poor pregnancy outcomes. In a resource poor setting, home delivery is considered very cheap, but the possible outcome of such ...Background: Inadequate antenatal care, both in coverage and standard, has been linked with poor pregnancy outcomes. In a resource poor setting, home delivery is considered very cheap, but the possible outcome of such pregnancies has been a subject of interest. This study evaluated the association of booking status with pregnancy outcomes. Objectives: To examine the factors that influence booking and impact of the booking status on pregnancy outcomes. Methods: This was a hospital-based prospective cohort study of 240 (120 booked and 120 un-booked) pregnant mothers selected through systematic random sampling. The study was carried out at the Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Nigeria. Chi-square test, t-test and logistic regression were used for analysis. Results: The mean age of the participants was 30.39 ± 5.05 years and 29.05 ± 6.36 years respectively for the booked and unbooked. Marital status (OR = 6.35, 95% CI = 1.24 - 32.59), educational status (OR = 36.40, 95% CI = 5.26-152.83), place of residence (OR = 0.15, 95% CI = 0.06 - 0.41), partner’s support (OR = 0.05, 95% CI = 0.01 - 0.37), family support (OR = 0.03, 95% CI = 0.01 - 0.13), mode of delivery (OR = 0.23, 95% CI = 0.12 - 0.46), APGAR score in first minute (OR = 6.02, 95% CI = 2.45 - 14.83) and NBICU admission (OR = 3.75, 95% CI = 1.67 - 8.43) were associated with booked status. However, being unmarried, nulliparity/grandmultiparity, low level of education, blue colar jobs, low income, rural dwelling and poor partner and poor family support were associated with the unbooked. The booked parturients had a better perinatal outcome compared the unbooked. Conclusion/Recommendation: There was high prevalence of operative deliveries, perinatal morbidity and mortality among the unbooked mothers. Girl child education, employment and poverty alleviation would improve antenatal care utilization.展开更多
文摘Background: Placenta praevia accounts for significant maternal morbidity and perinatal morbidity and mortality. Despite advances in blood transfusion technique and surgical procedure, abnormal placentation still remains a difficult challenge for obstetricians. Objective: To determine the influence of booking status on the fetal and maternal outcome among parturients with placenta praevia that underwent caesarian delivery. Methodology: This was a comparative and retrospective study between booked and unbooked subjects with significant placenta praevia that were delivered by caesarian section between January 1<sup>st</sup> 2004 and December 31<sup>st</sup> 2008 with respect to maternal and fetal outcome. Result: Out of 14,344 deliveries during study period, 123 cases of placenta praevia that underwent caesarian delivery were identified giving a prevalence rate of 0.86%. 49 subjects were booked while 74 were unbooked. There was no statistically significant difference between booked and unbooked cases with respect to risk factors (30.6% of booked and 23% of unbooked), X<sup>2</sup>(4) = 7.203, P = 0.126 and the mean blood loss at surgery (870.4 ± 486.9 ml in booked versus 779.7 ± 380.96 ml in unbooked), X<sup>2</sup>(1) = 0.202, P = 0.653. However, antepartum transfusion (12.2% booked versus 34.7% unbooked) and postpartum transfusion (51% booked versus 72% unbooked) showed statistically significant difference, X<sup>2</sup>(1) = 9.744, P = 0.002. One maternal death occurred amongst the unbooked cases and none among the booked cases. Statistically significant differences were also noted in the apgar score at 1 minute X<sup>2</sup>(3) = 15.528, P = 0.001 and 5 minutes X<sup>2</sup>(3) = 12.912, P = 0.005 respectively. More babies died in the unbooked group (19) compared to two (2) in the booked mothers. Conclusion: Unbooked status in placenta previa significantly increases the risk for antepartum and postpartum transfusion, is associated with higher mortality, increased preterm delivery, poorer apgar scores and higher perinatal mortality rate.
文摘Background: Inadequate antenatal care, both in coverage and standard, has been linked with poor pregnancy outcomes. In a resource poor setting, home delivery is considered very cheap, but the possible outcome of such pregnancies has been a subject of interest. This study evaluated the association of booking status with pregnancy outcomes. Objectives: To examine the factors that influence booking and impact of the booking status on pregnancy outcomes. Methods: This was a hospital-based prospective cohort study of 240 (120 booked and 120 un-booked) pregnant mothers selected through systematic random sampling. The study was carried out at the Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Nigeria. Chi-square test, t-test and logistic regression were used for analysis. Results: The mean age of the participants was 30.39 ± 5.05 years and 29.05 ± 6.36 years respectively for the booked and unbooked. Marital status (OR = 6.35, 95% CI = 1.24 - 32.59), educational status (OR = 36.40, 95% CI = 5.26-152.83), place of residence (OR = 0.15, 95% CI = 0.06 - 0.41), partner’s support (OR = 0.05, 95% CI = 0.01 - 0.37), family support (OR = 0.03, 95% CI = 0.01 - 0.13), mode of delivery (OR = 0.23, 95% CI = 0.12 - 0.46), APGAR score in first minute (OR = 6.02, 95% CI = 2.45 - 14.83) and NBICU admission (OR = 3.75, 95% CI = 1.67 - 8.43) were associated with booked status. However, being unmarried, nulliparity/grandmultiparity, low level of education, blue colar jobs, low income, rural dwelling and poor partner and poor family support were associated with the unbooked. The booked parturients had a better perinatal outcome compared the unbooked. Conclusion/Recommendation: There was high prevalence of operative deliveries, perinatal morbidity and mortality among the unbooked mothers. Girl child education, employment and poverty alleviation would improve antenatal care utilization.
