Background and Aim: Maternal morbidity is a major health problem affecting approximately millions of women annually and had a substantial influence on fetal and infant health that might lead to maternal mortality. Maternal mortality is an indicator of the quality of obstetric care in a community directly reflecting the utilization of health care services available. The present study was conducted in order to analyze the maternal morbidity and mortality cases referred to a tertiary care hospital. Methodology: This cross-sectional study was conducted on 89 maternal deaths out of 9874 obstetrical admissions or births referred to department of Gynae/Obs of tertiary care hospitals i.e Makran Medical College, Turbat/ Teaching Hospital, Kech and Dow University of Health Sciences, Karachi over a period of five years from 2017 to 2021. All the pregnant women with gestation age >24 weeks admitted for any obstetrical emergencies were enrolled in this study. Patient’s demographic characteristics, clinical features during admission, and maternal relevant information were collected on pre-designed proforma. SPSS version 21 was used for data analysis. Results: Out of total 9874 births, maternal deaths were 89; the mortality incidence with prevalence was hemorrhage 7 (7.9%), hypertensive disorders 34 (38.2%), anesthetic issue 2 (2.2%), sepsis 14 (15.7%), and medical complications 31 (34.8%). The occurrence of direct and indirect maternal death was 55 (61.8%) and 34 (38.2%) respectively. The incidence of the mortality rate was 22.9%. Of the total 387 morbidity cases, hypertensive disorders were the prevalent cause with 295 (76.2%) cases followed by obstetric hemorrhage 55 (14.2%), medical complications 25 (6.5%), sepsis 11 (2.8%), and anesthetic complications 1 (0.3%). The incidence of morbidity was 77.4 per year. Conclusion: Medical complications, sepsis, and hemorrhage are the leading causes of maternal mortality, followed by hypertensive disorders. Mortality and morbidity rates were 22.9% and 3.9% respectively. All of these causes can be avoided with proper antenatal care facilitation. Keywords: Hemorrhage, Maternal mortality, Sepsis
Background: During early pregnancy raised beta human chorionic gonadotropin (β-HCG) level occurs during placental development. It may be used for identifying the pregnancy induced hypertension. There are certain factors that causes pregnancy induced hypertension and preeclampsia. However, many of the associated factors and specific cause is not known. Some common risk factors for preeclampsia are nulliparity, preeclampsia in a previous pregnancy, family history, history of hypertension, renal disease and antiphospholipid antibody syndrome or thrombophilia. However no single lab investigation can be done cost-effectively to make the early diagnosis of pregnancy induced hypertension. The objective of this study was to determine the frequency of Pregnancy induced hypertension in patients with high maternal serum β-HCG at early pregnancy ( 13-20 weeks of gestation). Methodology: A descriptive cross sectional study was conducted on Out Patient Department and in patient wards of the Obstetrics and Gynecology Department of KRL General Hospital, Islamabad. The study was done from 28th December 2018 to 27th June 2019. A total of 75 pregnant women, primary gravida and multi gravida with age range from18-40years with raised β-HCG at 13-20 weeks of gestation were included. All patients were observed during their stay in the hospital for the development of any complications of pregnancy induced hypertension. Results: Mean age of pregnant females was 32.12 ± 5.29 years. Mean gestational period was 17.31 ± 2.05 weeks. Mean β-HCG levels was 7.63±3.71. Pregnancy induced hypertension (PIH) in patients with high maternal serum β-HCG at 13-20 weeks of gestation was found in 64 (85.33%) patients, however there was no Pregnancy induced hypertension in 11 (14.65%) ladies. Conclusion: The outcome of this study concluded that frequency of pregnancy induced hypertension in pregnant femal with high maternal serum β-HCG at 13-20 weeks of gestation was high. Early screening of raised β-HCG can be made for the prevention of complications due to pregnancy induced hypertension. Keywords: Beta Human chorionic gonadotropin, pre-eclampsia, pregnancy induced hypertension.
Objective: The aim of this study is to determine the adverse pregnancy outcomes in obese and non- obese women. Study Design: Randomized controlled trial Place and Duration: Department of Gyne & Obs, Shahida Islam Teaching Hospital Lodhran, during from 01-07-2020 to 31-07-2021. Methods: Total one hundred and eighty patients were enrolled in this study. Patients were aged between 18- 50 years. Patients detailed demographics were recorded after taking written consent. Patients were equally divided into two groups I and II. 90 obese patients were included in group I and equally non-obese patients were included in group II. Frequency of pre-eclampsia, gestational diabetes mellitus and post-partum haemorrhage were calculated. Adverse outcomes (cesarean section, instrumental delivery, induction of labor and prolong labor, hypertensive disorder) were also calculated among both groups. Fetal outcomes were perinatal mortality, Low birth weight, Low Apgar score and NICU admission were observed. Complete data was analyzed by SPSS 24.0 version. Results: Mean age of the patients in group I was 34.12±4.59 years with mean BMI 31.12±8.67 Kg/m2 and in group II mean age was 26.13 ±5.78 years with mean BMI 23.03±9.48 Kg/m2. Frequency of pre-eclampsia in obese group I were high among 40 (44.4%) patients as compared to group II 9 (10%) patients , frequency of gestational diabetes mellitus in group I was among 21 (23.3%) patients and 6 (6.7%) patients were in group II, post partum haemorrhage was seen in 57 (63.3%) cases in group I and 29 (32.2%) cases in group II. Fetal outcomes, perinatal mortality in group I 5 (5.5%) and in group II was 4 (4.4%), low birth weight in group I was among 21 (23.3%) and in group II was 45(50%), low apgar score in group I was 14 (15.5%) and in group II was 9 (10%), 43 (47.8%) in group I went to NICU admission and 28 (31.1%) patient in group II admitted to NICU. Conclusion: Pregnancy-related complications such as gestational diabetes, pre-term labour, and pre-eclampsia are more likely in obese women, according to our data. Having a baby with a woman who is obese might lead to serious difficulties for both mother and baby. Maternal obesity is connected with an increased risk of feto-maternal morbidity and mortality. Keywords: Pre-eclampsia, Gestational diabetes, Partum haemorrhage, Apgar score, NICU
Objective: The aim of this study is to determine the adverse adverse maternal and fetal outcomes in teenage pregnant women. Study Design: Randomized controlled trial Place and Duration: Department of Gyne & Obs, Shahida Islam Teaching Hospital Lodhran, during from 15-04-2020 to 31-03-2021. Material and methods: Total one hundred and twenty patients were enrolled in this study. Patients were aged between 14- 40 years. Patients detailed demographics were recorded after taking written consent. Patients were equally divided into two groups I and II. 60 patients of aged between 14-18 years were included in group I and equally patients of aged >18 were included in group II. Frequency of pre-eclampsia, gestational diabetes mellitus and post-partum haemorrhage were calculated. Adverse outcomes among (cesarean section, instrumental delivery,induction of labor and prolong labor, hypertensive disorder) were calculated among both groups. Fetal outcomes Perinatal mortality, Low birth weight, Low Apgar score and NICU admission were observed. Complete data was analyzed by SPSS 22.0 version. Results: Mean age of the patients in group I was 17.88±1.42 years with mean BMI 22.09±4.66 Kg/m2 and in group II mean age was 19.16±8.64 years with mean BMI 23.87±4.57 Kg/m2. Fetal outcomes, perinatal mortality in group I 8 (13.3%) and in group II was 5 (8.3%), low birth weight in group I was among 25 (41.7%) and in group II was 9 (15%), low apgar score in group I was 10 (16.7%) and in group II was 7 (11.7%), 12 (20%) in group I went to NICU admission and 4 (6.7%) patient in group II admitted to NICU. Frequency of pre-eclampsia in group I were high among 27 (45%) patients as compared to group II 13 (21.7%) patients , frequency of gestational diabetes mellitus in group I was among 14 (23.3 %) patients and 5 (8.3%) patients were in group II, post partum haemorrhage was seen in 42 (70%) cases in group I and 23 (38.3%) cases in group II. Conclusion: Delaying intrauterine development and premature neonatal intensive care admissions are also on the rise in this study. Anemia, urinary tract infection, high blood pressure pregnancy, and surgical delivery are all associated with pregnancies in which the mother is a teenager. Keywords: Pre-eclampsia, Partum haemorrhage, Maternal outcome, Fetal outcome
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