Prevalence of severe anemia and its feto maternal outcome in women who come in labour in a tertiary care hospital-A prospective study

Abstract

Background: The prevalence of anaemia in pregnant women is high due to illiteracy, ignorance, low socio economic status, lack of proper antenatal care, close birth spacing, multiparity. Aim& Objectives: To study the incidence of severe anemia with HB<=7gm% in women in labor
 To study the maternal outcome of severe anemia in labor
 To study the fetal outcome of pregnancy with severe anemia in labor
Methodology: It was a prospective study. The study was conducted at Kurnool Medical College, Kurnool during the period of November 2017 to October 2018. All pregnant women in labor with hemoglobin <=7gm% . Results: 10331 study subjects coming to delivery in labour room are taken. 7990 of cases (77.49%) are anemic. Among anaemic cases, severe anaemia (4-7g %) and very severe anaemia (<4g %) were onlytaken.364 cases were severely anemic. Among 364 cases, 22.8 %( 83) cases had very severe anaemia and 77.2 % ( 281) had severe anaemia. Majority of study subjects belonged to age group of 20-24 years – 60.99% of cases. 64.84 % of cases were belonged to low socio economic status. 60.44 % of cases were multigravida indicating the prevalence of anaemia in multigravida. 66.48 % of cases had birth spacing of <2years where as only 33.52 % had birth spacing ≥ 2years. 73.35 % of cases are unbooked. 10.16%, 3.3%), 28.57%, 31.59% of cases had weakness/fatigue, dyspnoea/palpitations, pedal edema and Preeclampsia respectively. 75.27% of cases had normal vaginal deliveries. 7.42% of cases had assisted vaginal deliveries (instrumental deliveries). 24.73% of cases underwent LSCS. The most common indication being Previous LSCS. 43.96 % of cases had preterm births. 46.43% of cases had term births. 9.62 % of cases had post term delivery. 2.47 % of cases had CCF. 0.59 % of cases had retained placenta. 8.52 % of cases had PPH. 7.69 % of cases as against had puerperal pyrexia. 3.3 % of cases had puerperal sepsis. 8.52 % of cases had sub-involution. 10.99 % of cases had lactation failure. 1.92 % of cases had episiotomy wound gaping. 4.12 % of cases had post LSCS wound gaping. 39.56 % of cases had low birth weight babies. 20.05% among cases had IUGR births. 15.66% neonates were admitted in the NICU. The neonatal morbidity was 16.21 % among cases. The Perinatal mortality was 2.2 % among cases. The average number of blood transfusion is 3 per subject among very severe anaemia group and 1 per subject in severe anaemia subjects. The maternal morbidity among cases was 31.32 %. There were 0.55% maternal deaths in the study subjects in the current study. 7.69% of the cases had ICU admission 7.14% of the cases contributed to near miss cases. Conclusion: It is recommended that good antenatal care be available, accessible and affordable to all pregnant women through partnership between government and nongovernmental organizations creating awareness through public health programmes and fortification of food which will improve the nutritional status of women.