Uncertain Gestation and Pregnancy Outcome at Omdurman Maternity Hospital 1996

Abstract

The proper management of every pregnancy is largely dependent on certain gestational age (GA). This study was conducted at Omdurman Maternity Hospital (OMH) during 1996. It is a comparative cohort study, designed to compare the pregnancy outcome of women with uncertain dates to those with certain gestational age, taking into consideration sociodemographic characteristics, and to find out the risk factors responsible for uncertain gestation. Total coverage of women attending delivery was employed, 443 subjects were studied and the data was collected through an interviewer-administered questionnaire. The results showed that the number of women with uncertain gestation was 190 (42.9%) while that of those with certain gestation was 253 (57.1%). Unknown last menstrual period (LMP) was the major contributory factor in uncertain gestational age. About half of subjects with uncertain gestational age were of rural origin compared to about one third with certain gestational age. Uncertain gestation decreased with increasing level of education and with improvement in socioeconomic status (SES). Grandmultiparity was commoner in uncertain gestation. Most women with uncertain gestation were unbooked for hospital delivery and they were poor antenatal care (ANC) attendants. In both groups ultrasound (U/S) scanning was either done late or not done at all. The study also showed that the rates of emergency caesarean section, preterm labour and low birth weight (LBW) were high among women with vii uncertain compared to those with certain gestational age. It is concluded that uncertain gestation has a strong association with adverse pregnancy outcome, mainly foetal. Therefore accurate dating early in pregnancy is an important factor for managing pregnancy properly and subsequently reducing these adverse outcomes. Health education through mass media highlighting this fact is recommended.