Gulrukh Qazi


Objective: The aim of this paper is to explore the relationship of various selected prenatal
circumstances to pregnancy outcome in particular reference to congenital anomalies. Method: It was a
cross-sectional analytical study and conducted at unit ‘A’ of the Department of Obs/Gyn, Postgraduate
Medical Institute, Lady Reading Hospital, Peshawar, from January to December 2009. The analysis
included data on all women having pregnancies with adverse outcome and various congenital
anomalies during the study period 1st January to 31st December 2009. A hospital-based maternal health
data was used from history records and direct interviewing of the patients subject to their availability
and information were recorded for all the cases on structured proformae. The data included
demographic details, social environment, consanguinity, ovulation induction, drug intake during early
pregnancy, exposure to radiation, infection during early pregnancy, complications of pregnancy,
prematurity, obstetrical variables, congenital anomalies and materno-foetal morbidity and mortality.
Findings at prenatal visits and data regarding prior pregnancies and morbidity among other children are
also abstracted from obstetrical and medical charts. In case of the newborn, the neonatal chart abstract
has proved to be a more complete source of information on congenital anomalies. The data was entered
on SPSS-10 and the analysis included simple proportions and rates. Results: Out of a total of 5,082
deliveries 163 (3.2%) were complicated by various congenital anomalies with prepondrence of neural
tube defects notably the hydrocephalous (33.4%) and Anencephaly (29.2%). Most of the mothers were
un-booked and uneducated (90%). Eighty- eight (54%) women were in there twenties, thirty (22%)
with ≥35 years of age and only 9%in the teenage group. About 36% of the deliveries in the study
population are among primigravida. Four cases (3.1%) had history of exposure to some non-specific
radiation due to the locality of there house. Almost 21% of couples had cousin marriage. Regarding
drug intake no specific link could be demonstrated as 45% took nothing while the remaining took the
multivitamins and tonics only. Only 4 cases (2.5%) had taken assisted conception in the form of
clomiphene citrate. About 34 per cent of the multigravida with antepartum bleeding reported that their
last prior pregnancy ended in a foetal death or prematurely born infant. The corresponding figure for all
multigravida women was 21 per cent. However, prior pregnancy history does not explain the more
adverse risk associated with APB. Conclusion: These results together provide information to
physicians and genetic counsellors to realise contribution of congenital abnormalities and setting
priorities of screening individual cases.
Keywords: Outcome, Prenatal, Pregnancy, Foetal, Counselling

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