Nargis Danish, Aneesa Fawad, Nasreen Abbasi


Background: Primigravida (PG), defined as a woman who conceives for the first time, is in a high-risk
group. Objective of this study was to evaluate the pregnancy outcome in booked and un-booked
primigravida. Methods: This was a hospital based comparative study conducted in Women and
Children Hospital Abbottabad from May 1998 to November 1999. A total of 322 patients were
included in the study. Inclusion criteria was all primigravida, both booked as well as un-booked
patients. Evaluation was done by taking detailed history, clinical examination and relevant
investigations. Antenatal, intrapartum and postnatal complications were noted in the mothers. Perinatal
morbidity and mortality was assessed in both the groups. Results: Out of 322 cases, 52 patients were
booked and 270 patients were un-booked. Majority of un-booked patients belonged to the rural areas
and were from lower socioeconomic group, between the age group of 15–35 years. The rate of
instrumental deliveries was high (87.5%) in un-booked patients as compared to booked patients
(12.5%). Caesarean section rate in un-booked patients was higher (76.5%) as compared to booked
patients (23.5%). Twenty-three (20%) patients of un-booked group presented in emergency mainly
with obstructed labour. Twenty-two (19.8%) patients had pregnancy induced hypertension, while
foetuses of 48 (43.2%) patients developed foetal distress. Antipartum haemorrhage was present in 12
(10.8%) patients, while prolonged labour with foetal distress was noted in 26 (23.4%) patients in unbooked group. Postpartum haemorrhage and puerperal pyrexia was more common in un-booked
patients (7.7% and 18.6% respectively). Perinatal mortality was high in un-booked patients (19.5%) as
compared to booked patients. Conclusion: Primigravida are high-risk patients. Comprehensive
antenatal care should be provided in this group of patients to have better maternal and foetal outcome.
Keywords: Primigravida, Pregnancy, Outcome, Complications, Women, Antenatal, Maternal, foetal

Full Text:



World Health Organization. The prevalence of anaemia in

woman. A tabulation of available information. Geneva:


Jackon DJ, Keel EB, Green SDR, Mokil JCK, Elton RA, Cutting

WAM. Severe anemia in pregnancy: A problem of primigravidae

in rural Ziar. Tren R Soc Trop Med Hyg 1991;85:829–32.

Garn SM, Ridella SA, Petzold AS, Falkner F. Maternal

hematologic levels and pregnancy outcomes. Semin Perinatol.


Allen LH. Iron deficiency. Increases risk of pre-term delivery.

Nutr Rev 1993;512:49–51.

Elia M. Nutrition. In: Kumar, Clark (eds). Clinical Medicine. 6th

ed. London: Saunders; 2005. p. 237–8.

Harrison KA, Ibeziako PA. Maternal anemia and fetal birth

weight. J. Obstet Gynaecol Br. Commonw 1973;80:798–804.

World Health Organization. Maternal Mortality Ratios and

Rates: a tabulation of available information. 3 edition,

WHO/MCH/MSM/91.6, Geneva; 1991.

Starrs A. Preventing the tragedy of maternal deaths. Report

on the international safe motherhood conference; Nairobi,

Kenya; 1987.

Severity of anaemia and operative mortality and morbidity.

Lancet 1988; 1(8599):1392–3.

Abu-Heija A, Ali AM. Is breech presentation in Nulli parous

women at term an absolute indication for caesarean section? Ann

Saudi Med 2001;21(3-4):190–2.

Hameed N, Ali MG. Maternal blood loss by expansion of

uterine incision at caesarean section–a comparison between

sharp and blunt techniques. J Ayub Med Coll Abbottabad

;16 (3) 47–50.

Stålberg K, Bodestedt A, Lyrenås S, Axelsson O. A narrow

pelvic outlet in creases the risk for emergency cesarean section:

Acta Obstet Gynecol Scand 2006: 2006; 85(7):821–4.

Al-Zirqi 1, Vangen S, Forsen Letal: Effect of onset of labor and

mode of delivery on severe post partum haemorrhage. Am J Obst

Gynecal: 2009;201(3):1–9.

Lotez AO. Causes of death an assessment of global pattern of

mortality around 1985. Word Health Stat Quart 1990;43:91–104.

Korejo R, Jafary N. Perinatal mortality in Jinnah

Postgraduate Medical Centre Karachi; J Pak Med Assoc


Glanzner CM, Abdullah MI, Russel IT, Templeton AA.

Postnatal care a survey of patients experiences, Br J

Midwifery 1993;1:67–74.


  • There are currently no refbacks.

Contact Number: +92-992-382571

email: [jamc] [@] []