Renuga Devi, C (2008) Maternal and fetal outcome in teenage pregnancy. Masters thesis, Kilpauk Medical College, Chennai.
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Abstract
The incidence of teenage pregnancy during the study period in KMCH was 9.6%. · 2/3 of pregnant teenagers were 19 yr olds, and almost the rest belonged to the 18 yrs category. Only 2.33% belonged to the 15 - 17 yrs category. Among the control group, about half of the population belonged to 20 - 22 yrs group. · Women in the study group had a mean age at marriage of about 17.08 yrs whereas women in the study group had a mean age of marriage of about 21.52 yrs. · 1.33% of the study group were unmarried whereas all were married in the control group. The unmarried women were illiterate and lacked basic knowledge about pregnancy. Ignorance about safe sex and casual relationship had led to this situation in them. · 17% of the study group were illiterate and 13% of the control group were illiterate. About ½ of the study group have stopped attending school after primary level of education whereas more than half of the control group have attended school till secondary level. · None of the women in the study group have attended college whereas 3.66% of the control group had college education after school education. · Most of the women in both the groups were not working and were solely dependent on their husbands for their living. About 9.66% of the study group belonged to the working category which made them financially independent. · Only 1/6 of the study group had awareness about pregnancy and its complications whereas about 1/3 of the control group had enough knowledge. They acquired the knowledge from books, media and from friends. · 14% of the women in the study group were unbooked i.e. they didn’t have adequate antenatal checkup whereas only 4.66% of the women in the control group didn’t have adequate antenatal checkup. · Almost all patients have had 2 doses of TT in both the study and control group except one patient in the study group who was an unmarried teenager. · 12% of women in the study group booked in the I trimester whereas 30% of women in the control group booked during the I trimester. 14% of the women in the study group had their first visit during III trimester after they had developed complications and 4% of women in the control group had their first visit during III trimester. · Height of most of the women ranged between 146 - 150 cm, the average height in Indian women. 8% of women in the study group were short statured i.e. <145 cm and 3% of women in the control group were short statured. · There was not much difference in the weight between the study and control group. · Mean Hb in study group was 9.58% which belongs to moderate anemia category and mean Hb in control group was 10.11 g% which belongs to mild anemia category according to ICMR classification of anemia. Severe anemia is more common in the study population than the control population. · Pregnancy induced HT was prevalent in both the groups because they were primigravidae. Incidence of mild PIH was almost same in both the groups. Incidence of severe PIH was 3.66% in the study group and was 1% in the control group. Incidence of eclampsia was 1.66% in the study group and 0.33% in the control group. · Among other complications, incidence of malpresentation and malposition was not significantly different. · 2 patients in the study group had intrauterine death. · 5 patients had IUGR in the study group and 2 patients had IUGR in the control group. · There was 1 case of abruptio placenta in the study group. · 10.66% of the study group had cephalopelvic disproportion whereas 8.66% of the control group had cephalopelvic disproportion. · 9% of the study group had prelabour rupture of membranes whereas 7.66% of the control group had the same. · 6 patients from the study group had prolonged labour and 1 patient had prolonged labour among the control group. One patient from the study group had precipitate labour. · All complications occurring postpartum such as local sepsis, mastitis and UTI were increased in the study group than in the control group. · There was not much difference in the mode of delivery between the 2 groups. Labour naturale was 58.66% in the study group and 57% in the control group. Caesarean rate was 35.33% in the study group and 38% in the control group. Instrumental delivery was seen in 4.33% among the study group and 4.66% among the control group. · About 38.66% of babies born to mothers in the study group were low birth weight (<2.5kg). About 25.66% of babies born to mothers in the control group were low birth weight. · About 1/3 of babies born to mothers in the study group required NICU admission whereas only 1/5 of babies born to mothers in the control group were admitted in NICU. · Leading causes of admission in NICU were respiratory distress and LBW / preterm babies. 16.33% of babies born to mothers in the study group had respiratory distress and 7% of babies born to mothers in the control group had respiratory distress. · 14% of babies born to mothers of study group required admission for low birth weight / prematurity whereas 10% of babies born to mothers of control group required admission for the same. · Incidence of sepsis was same in both the groups. · 2 babies from the study group had milk aspiration preumonitis as the mothers had no idea how to feed the babies. · 6.66% of the babies born to mothers of the study group expired whereas 1.66% of the babies born to mothers of the control group expired. Main reason for perinatal loss in both the groups was prematurity. CONCLUSION Teenage pregnancy is a serious problem today all over the world and more so in developing countries like India. Throughout the world, various measures are being taken to prevent teenage pregnancy. Educating and creating awareness about the perils of teenage pregnancy is the best approach for this problem. In U.S., a national campaign has been started in February 1996 with the goal to reduce teen pregnancy rate by 1/3 over 10 yrs and in 2006, the goal was again revised to reduce teen pregnancy rate by another 1/3 between the years 2006 - 2015 24 In U.S. schools, a popular video `Too young’ is being telecasted, where teen parents from a variety of backgrounds share their stories and in their own words offer their candid view about the difficulties they have faced. In the same lines, Jason Reitman, has directed a film `Juno’ which is about the pathetic situation of an American teenager facing an unplanned pregnancy and the film has won the best film award at Rome film festival in October 2007. In Jharkand, a 16 hour course prepared by UNESCO, named `Learning for life’ `Jeevan ke liye siksha’ has been made compulsory for class 11 and class 12 students which educates about HIV, STDs, teenage pregnancy and ways to prevent it. All over India, 2 programmes have been initiated by FOGSI. `Growing Up’ program initiated by FOGSI in partnership with Johnson and Johnson educates schoolgirls on menstruation, its myths and hygeine, anatomy and functioning of the reproductive system, value of good nutrition and exercises, problems of drugs alchohol and smoking and about sexual abuse. Another program `Let’s talk’ initiated by FOGSI in association with Organon educates college going women about various forms of contraception. ‘Teenage girl clinic’, set up in various Government hospitals tackles various problems encountered by teenage girls and distributes iron tablets to teenage girls to improve adolescent health. ‘Family Welfare Clinic’ offers excellent services in the form of contraceptive measures including emergency contraception and by providing with MTP services in case they get pregnant. With these measures, we can hope to eradicate teenage pregnancy at least in the future generation, just as we have brought 100% immunisation among antenatal women through various Government programmes. The present approach is to provide general health education about the risks of teenage pregnancy, strictly enforce the minimum age at marriage law, screen all pregnant mothers for risk factors and provide at risk mothers with education about childbearing and rearing and referral to a tertiary hospital for safe delivery. A multidisciplinary approach involving educationists, health workers, social workers and obstetrician and gynaecologists is required to improve the adolescent’s reproductive health.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | Maternal and fetal outcome ; teenage pregnancy. |
| Subjects: | MEDICAL > Obstetrics and Gynaecology |
| Depositing User: | Subramani R |
| Date Deposited: | 08 Dec 2017 01:49 |
| Last Modified: | 08 Dec 2017 01:49 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/4277 |
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