Abstract
Background: When Pregnancy is associated with an underlying medical disorder, it has a large impact on the well-being of a mother. So to determine the prevalence and pattern of various medical disorders in pregnancy is very important.
Aim: This study seeks to retrospectively determine the incidence of medical disorders in pregnancy, and also determine their impact on fetal and maternal outcome.
Materials and Methods: This was a retrospective study of all medical cases in pregnancy managed in TAGORE MEDICAL COLLEGE AND HOSPITAL from 1st of January 2017 to 31st October 2019. Data were analyzed and results were presented in simple tables. Test statistics was set at 95% confidence interval.
Results: A total of 198 medical cases in pregnancy of 2418 admissions were managed during the study period (8.2%). Mean (SD) age of the women was 30 years and age ranged 18-42 years for about 198 cases that had the age documented. Most common medical disorder was pregnancy induced hypertension and its complication seen in 38.85% of the females, followed urinary tract infection seen in 19.19% patients. Caesarean section rate in women with medical condition in pregnancy was higher than in the control group (69.6% vs. 34.2%). Maximum perinatal morbidity was seen in females suffering with hypertensive disorders (53.4%), with 12 (54.5%) IUGR and 2(40%) intra uterine demise respectively.
Conclusion: There is relatively little change in the incidences of medical complication over the period of time. Preventive strategies may have reduced the prevalence over the years. However, more effort is needed to markedly reduce the medical complications in pregnancy.
Keywords: Medical disorders, Pregnancy, Prevalence, Hypertension, Fetal outcome, Maternal outcome
References
- Knight M , Tuffnell D, Kenyon S et al. S aving lives, improving mothers’ care: surveillance of maternal deaths in the UK 2011–13 and lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009–13 . Oxford : University of Oxford , 2015 .
- Reduction of Maternal Mortality: A joint WHO/UNFPA/UNICEF/World bank statement. Geneva: World Health Organization; 1999. p.14. Available from: http://whqlibdoc.who.int/publications/1999/9241561955_eng.
- Ngaira JAM, Kimotho J, Mirigi I, Osman S, Ng’ang’a Z, Lwembe R, Prevalence, awareness and risk factors associated with hepatitis B infection among pregnant women attending the antenatal clinic at Mbagathi District Hospital in Nairobi, Kenya. Pan Afr Med J 2016;24:315.
- Glazener CMA, Abdalla M, Stroud P, Naji S, Templeton A, Russell IT. Postnatal maternal mortality: Extent, causes, prevention and treatment. Br J Obstet Gynaecol 1995;102:282-7
- Trends in maternal mortality: 1990 to 2013. Estimates by WHO, UNICEF, UNFPA. The World Bank and the United Nations Population Division;2014. ISBN 978 92 4 150722.
- Kersten I, Lange AE, Haas JP. Chronic disease in pregnant women: Prevalence and birth outcomes based on the SNiP study. BMC Pregnancy Childbirth 2014;14:75.
- Yücesoy G, Ozkan S, Bodur H, Tan T, Calişkan E, Vural B, et al. Maternal and perinatal outcome in pregnancies complicated with hypertensive disorder of pregnancy: A seven year experience of a tertiary care center. Arch Gynecol Obstet 2005;273:43-9.
- Magee L, von Dadelzen P, Rey E et al. Less tight versus tight control of hypertension in pregnancy. N Engl J Med 2015 ; 372 : 407 – 17 .
- Dawkins JC, Fletcher HM, Rattray GA, Reid M, GordonStrachan G. Acute pyelonephritis in pregnancy: a retrospective descriptive hospital based-study. ISRN Obstet Gynecol.2012; 6. doi:10.5402/2012/519321.
- Management of urinary tract infections in adults. Scottish Intercollegiate Guidelines Network. Guideline No. 88. SIGN; 2006: 13-15.
- Le J, Briggs GG, McKeon A, Bustillo G. Urinary tract infections during pregnancy. Ann Pharmacother 2004;38:1692-701.
- Dangour AD, Hill HL, Ismail SJ. Haemoglobin status of adult non-pregnant Kazakh women living in Kzyl-Orda region, Kazakhstan. Eur J Clin Nutr. 2001; 55: 1068-1075.
- Shah TM, Mishra K, Ninama P, Parikh C . Diseases with pregnancy – a study of maternal and fetal outcome. IAIM. 2015;2(1);22-9.
- Yong TT, Tay SK. Medical Disorders Ahead. Editorial. Ann Acad Med 2002;31:33.
- Bishnoi A, Sachmechi I. Thyroid disease during pregnancy. Am Fam Physician 1996;53: 215-20.
Corresponding Author
Dr Sherin Raja Janaki Davidbaskaran
Assistant Professor, Department of General Medicine, Tagore Medical College And Hospital. Rathinamangalam, Chennai-600127, India
DOI: https://dx.doi.org/10.18535/jmscr/v7i11.158
