RELATIONSHIP OF SELECTED PRENATAL FACTORS TO PREGNANCY OUTCOME AND CONGENITAL ANOMALIES
Abstract
Objective: The aim of this paper is to explore the relationship of various selected prenatalcircumstances to pregnancy outcome in particular reference to congenital anomalies. Method: It was across-sectional analytical study and conducted at unit ‘A’ of the Department of Obs/Gyn, PostgraduateMedical Institute, Lady Reading Hospital, Peshawar, from January to December 2009. The analysisincluded data on all women having pregnancies with adverse outcome and various congenitalanomalies during the study period 1st January to 31st December 2009. A hospital-based maternal healthdata was used from history records and direct interviewing of the patients subject to their availabilityand information were recorded for all the cases on structured proformae. The data includeddemographic details, social environment, consanguinity, ovulation induction, drug intake during earlypregnancy, 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 arealso abstracted from obstetrical and medical charts. In case of the newborn, the neonatal chart abstracthas proved to be a more complete source of information on congenital anomalies. The data was enteredon SPSS-10 and the analysis included simple proportions and rates. Results: Out of a total of 5,082deliveries 163 (3.2%) were complicated by various congenital anomalies with prepondrence of neuraltube defects notably the hydrocephalous (33.4%) and Anencephaly (29.2%). Most of the mothers wereun-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 studypopulation are among primigravida. Four cases (3.1%) had history of exposure to some non-specificradiation due to the locality of there house. Almost 21% of couples had cousin marriage. Regardingdrug intake no specific link could be demonstrated as 45% took nothing while the remaining took themultivitamins and tonics only. Only 4 cases (2.5%) had taken assisted conception in the form ofclomiphene citrate. About 34 per cent of the multigravida with antepartum bleeding reported that theirlast prior pregnancy ended in a foetal death or prematurely born infant. The corresponding figure for allmultigravida women was 21 per cent. However, prior pregnancy history does not explain the moreadverse risk associated with APB. Conclusion: These results together provide information tophysicians and genetic counsellors to realise contribution of congenital abnormalities and settingpriorities of screening individual cases.Keywords: Outcome, Prenatal, Pregnancy, Foetal, CounsellingReferences
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