Irum Gilani, Ziyad Afzal Kayani

Dr. Irum Gilani, Azad Jammu & Kashmir Medical College, Muzaffarabad

Abstract

Objective: To retrospectively analyze earlier health care seeking for pregnancy related complications in obstetric cases admitted for childbirth at a tertiary care level facility of district Muzaffarabad, Azad Jammu & Kashmir (AJK).
Study Design: Retrospectively analyzed cross-section.
Place and Duration: The study was conducted from January 2011 to July 2011 at Abbas Institute of Medical Sciences (AIMS) hospital situated in district Muzaffarabad of AJK.
Methodology: All pregnant women admitted for childbirth at Abbas Institute of Medical Sciences (AIMS) hospital situated in district Muzaffarabad of AJK. Case histories of obstetric cases admitted in Obstetric & Gynecological ward were retrieved from the data base of this tertiary care level facility. After initial scrutiny, records of pregnant women with complications of pregnancy, were selected for further analysis of their earlier health care seeking. From this retrospectively analyzed cross-section, records of 235 eligible pregnant women with pregnancy, related complications were selected. Complications included anaemia (86%), bleeding including APH & PPH (9%), hypertension and other medical conditions (5%). For the purpose of this study, cases that had been diagnosed and recorded as such in the database of the AIMS hospital were taken as bleeding, antepartum haemorrhage (APH) and postpartum haemorrhage (PPH). Whereas, pregnant women with hemoglobin (Hb) level of less than 10 gm/dl were taken as anaemic in our study. Close-ended questionnaire utilized for the analysis of earlier health care seeking for pregnancy related complications included variables such as urban/rural place of residence, distance (in km) travelled by the pregnant women to reach AIMS hospital, antenatal care (ANC) received/not received, presence/absence of first level care facility (FLCF) between residence and the AIMS hospital, referred/not referred obstetric cases, hemoglobin level checked at AIMS hospital and availability/ non-availability of previous record of hemoglobin testing or treatment for anaemic pregnant women. Data was analyzed using SPSS version 16.
Results: More than 70% of the pregnant women who delivered at the AIMS hospital belonged to the surrounding villages of the district Muzaffarabad while remaining women were from the urban population. Only 18% of the pregnant women in this study had received some kind of ANC during their current pregnancy. Eighty seven percent of pregnant women in our study were found to be anaemic. Ninety nine percent of the anaemic women did not have any previous record of hemoglobin testing or treatment of their anaemia.
Conclusion: Majority of women with pregnancy related complications did not seek antenatal care, had not utilized the nearby primary healthcare facilities available in the district Muzaffarabad. Intervention needs to be planned and implemented to enhance the primary health care utilization in AJK.
Key words: Pregnancy related complications, first level care facility, anaemia, Muzaffarabad.