Outcome of unbooked pregnancies at the Federal Medical Centre, Owerri, Nigeria

Abstract

Background: Booking in pregnancy has been found to significantly influence the maternal and perinatal outcome of pregnancy. Unbooked pregnancies contribute to adverse maternal and perinatal outcomes. Some paturients in Owerri, South eastern Nigeria and environs have the erroneous idea that booking was not important for safe motherhood.

Objectives: The study was to determine the maternal and perinatal outcomes of unbooked versus booked  pregnancies.The maternal outcomes examined included normal deliveries, instrumental vaginal deliveries, caesarean sections and maternal mortality. The perinatal outcomes included an evaluation of Apgar scores and perinatal mortality.
Design: It was a retrospective comparative study
Setting: The study was carried out at the Federal Medical Center,Owerri South-eastern Nigeria between January, 2010 and December, 2011.

Methodology: The labour ward records of all deliveries in the Centre between January 2010 and December 2011were examined and data collected from the theatre and Special care baby unit to determine the maternal and perinatal outcomes. Paturients who registered their pregnancies and received antenatal care in the Centre were termed booked, while those seen in labour for the first time irrespective of whether they registered elsewhere or not, were termed unbooked. Data was analysed using standard electronic calculators.

Results: There were a total of Six thousand, six hundred and seventy five (6675) deliveries within the period under review with a total of 680 unbooked pregnancies giving an overall incidence of 10.2%. The incidence was10.12% for 2010 and 10.24% for 2011respectively. In all the indices used to assess maternal and perinatal outcome, there was a more favourable outcome in the booked parturients compared to those who were unbooked.

Conclusion: The study goes on to re- emphasize the contribution of the unbooked mother to bad obstetric indices. The unbooked mother increases the risk of operative deliveries, maternal mortality, birth asphyxia and perinatal mortality.