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Evaluation of Maternal and Perinatal Mortality Ratio in Primary Health Care Centers using Ultrasound in the period 1-6-2006 to 31-12-2008

Show simple item record Hagelhassan,Tagelsir Elsaddek Supervisor-Mutasim Ahmed Alseed 2014-02-09T12:02:03Z 2014-02-09T12:02:03Z 2009-01-01
dc.identifier.citation Hagelhassan,Tagelsir Elsaddek ,.Evaluation of Maternal and Perinatal Mortality Ratio in Primary Health Care Centers using Ultrasound in the period 1 -6-2006 to 31-12-2008 / Tagelsir Elsaddek Hagelhassan;Mutasim Ahmed Alseed.- Khartoum : sudan university of science and technology,Medical Radiologigc Sciences,2009.- 159p. : ill ;28cm .-M.Sc en_US
dc.description Thesis en_US
dc.description.abstract The main objective of this research was to explore the efficacy to reduce maternal and perinatal mortality by using regular ultrasound checks during pregnancy in primary health care centers. The study was carried out during the period 1.6.2006-31.12.2008. It was a prospective interventional cohort study. Pregnancies followed from registration till seven days after birth. The study took place in two primary health care centers selected randomly with once a week antenatal clinic was held regularly in each health center. Subjects included were 1000 selected in a random way during antenatal clinics at Tegani Sheriff and Kadaro primary health care centers. Pregnancies were classified into risky or normal and a low threshold for referral of women having risks was adopted to share antenatal care with secondary and tertiary levels of health when more facilities required. Difficulties faced the researcher included inability to do laboratory investigations, not taking iron supplements, home deliveries and resistance to hospital referrals. Main outcome measures included maternal mortality, stillbirths, early neonatal and perinatal mortality, referrals, risky pregnancies, mode of delivery and complications of labour. No cases were lost to follow up. Results obtained were; the common & average age of the women at pregnancy was between 16 and 34 years (87.5 %) while those below 16 years represent 2.7 % and those above 34 years 09.8%. Parity mostly (1-4) counting to (45.4%) and primigravidas (30.2%) were more than parity 5 or >5 which counted (24.4%) of the sample. (1000) cases were studied (17) miscarriage pointed to (1.7%) abortion rate. The perinatal mortality rate was 14 per 1000 births, the rate of stillbirth was 13 per 1000 births, and the early neonatal mortality was 1.0 per 1000 live births. Risky cases were; 285 has no risk, 208 of low risk & 506 of high risk representing 28.5%, 20.8 % and 50.6% respectively. Pregnancies of low and high risk (Risky group = 71.4%). Referrals; 75.6% of cases referred to hospitals and higher centers 58.5% referrals were due to maternal reasons, 9.6% for fetal reasons and 7.5% due to combined maternal and fetal reasons. Mode of delivery; 91.9% ended in normal labour, 5.6% delivered by cesarean section and 0.8% assisted by forceps. None was assisted by ventouse. Complications included antepartum bleeding in 8 cases equal to 0.8%, PPH in 5 women equal to 0.5%, malaria in 11 cases representing 1.1% of the sample, low-lying placenta found in 22 women i.e. 2.2% of the sample, amniotic fluid abnormalities of 05.9%; 2.8% as oligo and 3.1% as polyhydramnios. Diabetes mellitus and gestational diabetes found in 1.1% of cases while hypertensive diseases occurred in 4.5% of the sample. On the other hand urinary tract abnormalities found in 21.4% of cases of which UTI counted to 103 cases (1.03%) whereas anemia found in 31.9% of cases. Women who were found to know their last menstrual period (LMP) count to 70.3% while those who do not know it were 297 women i.e 29.7% of the sample. Perinatal deaths in these occurred in 6-cases i.e. 2% of the group. The researcher concluded that; antenatal care clinics supplemented by regular U/S checks at the level of primary health care is a useful way for keeping maternal and perinatal mortality ratios at a low rate. It is also represents a useful source of data for studying maternal and perinatal mortality. There were no maternal mortalities while perinatal mortality ratio was lower than officially reported ratio of 38/1000 (Zero for MMR and 1.4% for PNMR (14 per 1000) births). The perinatal death ratio is approaching that reported in developed and western countries. Therefore, U/S service in PHC centers is an effective tool and the study proved the proposal. It supported primary health care to be the best tool to provide health for all if upgraded as empowerment by ultrasound in this research has improved one of the most important items of primary health care reflected as improvement in maternal and perinatal mortality ratios to acceptable levels. en_US
dc.description.sponsorship sudan university of science and technology en_US
dc.language.iso en en_US
dc.publisher sudan university of science and technology en_US
dc.subject Evaluation en_US
dc.subject Ultrasound en_US
dc.title Evaluation of Maternal and Perinatal Mortality Ratio in Primary Health Care Centers using Ultrasound in the period 1-6-2006 to 31-12-2008 en_US
dc.type Thesis en_US

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