Adolescent Pregnancy; A Comparative Study From the Teaching Hospital of Lahore, Pakistan

Abstract

ABSTRACT… Objectives:To compare the obstetric outcomes in adolescent and adult primigravida. Study Design: A comparative, cross sectional study. Setting: Gynae unit 3, Jinnah hospital, Lahore. Period: One year from Jan-Dec 2014. Methodology: Study population was adolescent primigravida (<19 years) and adult primigravida between the ages 20-29 years, 250 in each group who were > 24 weeks of gestation. Obstetric complications were recorded as percentages of anaemia, pre-eclampsia, antepartum hemorrhage, postpartum hemorrhage, gestational diabetes mellitus, preterm delivery, instrumental delivery, cesarean section rate, low birth weight, Apgar score <7 at 5 minutes and NNU admission. Data was entered into SPSS 16. Chi square test applied and a p-value of<0.05 was considered significant. Results: The mean age of adolescent group was 18.4+ 0.56 years while it was 24+2.47 years in adult primigravida. The data revealed that the adolescent mothers are at higher risk of certain obstetric risks when compared to adult primigravida .These include anaemia ( 41.2% VS 17.6%), pregnancy induced hypertension (14.4% VS 1.6%), preterm delivery (21.6% VS 13.6% ), instrumental delivery (6.4% VS 1.6%), cesarean section rate (24% VS 12%), low birth weight (20.4% VS 8%), Apgar score <7 at 5 minutes (4% VS 2%) and NNU admission (19.2% VS 8%). The risk of antepartum hemorrhage (1.6% VS 1.2%), postpartum hemorrhage (0.8% VS 1.6%), gestational diabetes mellitus (1.2% VS 2%) and malpresentation (1.6% VS 2%) were not different in two groups. Conclusion: Adolescent pregnancy is associated with a higher rates of certain obstetric risks like anemia, preterm delivery, pregnancy induced hypertension, instrumental delivery, cesarean section and poor neonatal outcome However the risk of antepartum hemorrhage, postpartum hemorrhage and malpresentation is no greater than adult pregnant mothers. Key words:Adolescent pregnancy, outcome.

A study to assess patient satisfaction in out patient department of a tertiary care hospital in north India

“…The satisfaction level regarding doctor consultation was around 97% which is much higher than as reported by kersnik et al, (55.3%); Kumari et al, (73%); Syed Shuja Qadri et al, (66.8%), Sultana et al, Tasneem A et al, Pakistan, (95.5%). 2,12,19,20 Our study shows a low level of satisfaction (31.6%) regarding canteen/food facilities, (25.6%) pharmacy services and (31.1%) transport facility. Proportion of patients satisfied with canteen services found in our study is still a higher as compare to studies reported earlier by Aleena et al (18%).…”

“…19 While proportion of patients satisfied with pharmacy are low as reported earlier. [19,20] As our sample size was very small, we merged the departments into three broader categories; namely surgery, medicine & others. Both referral pattern & patients satisfaction were not found to be associated with the department where patients reported.…”

An evaluation of the in-patient feedback services in a tertiary care hospital of Northern India

“…41.6% to 46.8% patients rated cleanliness of rooms and toilets, timely availability of housekeeping staff and overall hospital cleanliness poorly (average scores being less than 3.5 for most criteria for housekeeping services) which is higher than the 35.5% of the respondents dissatisfied by the toilet facilities in a study by Qadri SS et al, but significantly lower than that of another study by Aleena et al with 80% level of dissatisfaction. 20,21 Between 43% to 55% patients were unhappy with the dietary services and low scores (less than average 3.5) were given to all four criteria under diet (quality of food, quantity of food, timely delivery of food, diet as per doctor's advice wherever applicable).This is in line with a study conducted at a tertiary care hospital in Nagpur, India where 51.93% admitted patients were unsatisfied with quality of food, but is in contrast to other studies by Qadri et al and Aleena et al, with low dissatisfaction rates of 18.25and 18% respectively. [20][21][22] 68.2% patients said they were mostly informed timely by the treating doctor/nurse about their discharge, but the discharge process was long and tedious (turn-around time for discharge process noted by patient on the feedback form).…”

“…20,21 Between 43% to 55% patients were unhappy with the dietary services and low scores (less than average 3.5) were given to all four criteria under diet (quality of food, quantity of food, timely delivery of food, diet as per doctor's advice wherever applicable).This is in line with a study conducted at a tertiary care hospital in Nagpur, India where 51.93% admitted patients were unsatisfied with quality of food, but is in contrast to other studies by Qadri et al and Aleena et al, with low dissatisfaction rates of 18.25and 18% respectively. [20][21][22] 68.2% patients said they were mostly informed timely by the treating doctor/nurse about their discharge, but the discharge process was long and tedious (turn-around time for discharge process noted by patient on the feedback form). Courtesy and behavior of cash counter staff were mostly found satisfactory (average score 3.5) by 60% of patients.…”

Patient Satisfaction With Health Care Services In Outpatient Department Of A Dental College Hospital In Pakistan

“…The findings of the study by Hassan Soleimanpour et al [14] , on emergency department patient satisfaction survey in Imam Reza Hospital, Tabriz, Iran revealed that the satisfaction level of patients in regard to the information given by care provider about medication was very good in 49.4% of patients. The study [15] in a tertiary care teaching hospital in Pakistan on patient satisfaction: A comparative study at teaching versus DHQ level hospital in Lahore, Pakistan; noted that location of hospital was convenient in 38% of patients for teaching hospitals and 42% of patients for DHQ level hospital; while 80% of patients in teaching and 95% in DHQ level hospital were satisfied with the time waited by them to be seen by doctor. And regarding satisfaction level of patients with the amount spent for medical needs, medications available free of cost in the hospital were 74% and 76% for teaching hospitals, and 95% each for DHQ level hospital respectively.…”