Impact of Antenatal Care on Maternal and Perinatal utcome: A Study at Nepal Medical College Teaching Hospital

Abstract

NJOG 2011 Nov-Dec; 6 (2): 37-43 Aims: To identify the determinants of antenatal care (ANC) attendance and its impact on maternal / perinatal outcome.Methods: Prospective descriptive study of women delivered at Nepal Medical College Teaching Hospital (NMCTH), a 700 bedded tertiary care hospital situated at periphery of Kathmandu.Results: Among 322 women delivered during period of four months, majority (87%) reported of attending more than 4 antenatal visits, only 21 (6.5%) women had not attended ANC. The most preferred place of ANC was hospital (71.6%). Women with secondary education and above, business/service holders, 20-29 years age group, primigravida and Brahmin likely to attend. Financial problem (52.4%) followed by ignorance (28.6%) were the most commonly stated reasons for not attending ANC. Women attending attending more than 4 antenatal visits have more chance of full immunization with tetanus toxoid and iron supplementation. Most of the women started attending ANC from their second trimester (75.8%), women who had attended ANC, because of the fact that all elective cesarean section were planned in these women only. Also, all inductions of labor (9.3%) were performed among them. Maternal complications like anemia and pregnancy induced hypertension occurred more commonly in women without ANC. The proportion of low birth weight and preterm babies was higher in women with inadequate or no ANC. Special care baby unit (SCBU) admission was also higher among them due to various reasons like neonatal sepsis, birth asphyxia, jaundice etc. While there were no neonatal deaths during the study period, 3 still births have occurred. Perinatal mortality rate was similar in no ANC and inadequate ANC groups; it was 16 times higher than that in the group with more than 4 visits. Maternal and perinatal outcomes were found to be better in women who attended regular ANC. Conclusions:trimester is low. The quality of antenatal care needs to be strengthened. The health system needs to ensure the availability of ANC in primary care level and to establish mobile clinics for those living far from the health facilities.

Status of neonatal death in sick newborn care unit of a tertiary care hospital

“…In a Study conducted in Kathmandu it was found that peri natal mortality was 16 times higher among no ANC or inadequate ANC than that in the group with more than 4 visits. 9 An analysis of District Level Household Survey (2007-2008) conducted in India too revealed results similar to present study. 10 In our research, we put assisted delivery and Caesarian section together and tried to find out the association between modes of delivery and neonatal death.…”

Ante natal care utilization and delivery services in a tertiary care hospital

“…228 (75.8%) started to attend ANC only in 2 nd trimester and only 66 (21.9%) had started from 1 st trimester. 11 In the study conducted by Dasgupta Urmila et al on ante natal care utilization from a metropolitan city revealed that 36.5% of mothers had done ante natal registration in first trimester which is similar to our study. 9 Registration of pregnancy is essential to provide the effective care & follow up care of the mother.…”

Focused antenatal care utilization and associated factors in Debre Tabor Town, northwest Ethiopia, 2017

“…This finding appeared to be lower than studies done in Ethiopia (Eastern Hararghe zone 38.3% [13] and Holeta town 66% [14]) and abroad Kenya 52% [15], Nigeria 81.5% [16] and Nepal 87% [17]. The probable reason for this might be due to availability of private quality service providing health facilities and also availability of approachable healthcare providers.…”