title: Perinatal outcome in high risk pregnancies.
abstract: OBJECTIVE
  To determine the perinatal outcome of high risk pregnancies, in terms of perinatal mortality, Apgar score, birth weight and neonatal complications in first week after birth.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  Obstetric Department of Sir Syed Trust Hospital, Karachi, from January to December 2007.
  
  
  METHODS
  All antenatal patients attending the Outpatient Department were interviewed, after informed consent. Those who fulfilled the required criteria were grouped in 2 categories; high risk (group A cases) and low risk (group B control) pregnancies according to the risk factors identified in the history. All singleton pregnancies from 28th weeks of gestation till delivery were included in the study. All pregnant women, who had multiple pregnancies or congenital malformations were excluded. Patients were followed till delivery and neonatal outcome was assessed in both the groups. Outcome measures were recorded.
  
  
  RESULTS
  There were a total of 282 patients studied. The number of patients in group A were 162 and in group B, 120. Anaemia 98 (60.49%), pregnancy induced hypertension 24 (14.8%) and preterm labour 26 (16%) were identified as the major risk factors in group A. There were 12 (7.40%) stillbirths and 5 (3.08%) early neonatal deaths in group A, while there was 1 (0.84%) stillbirth and no neonatal death in group B (p=0.004, RR=1.72). There were 58 (35.80%) neonates with low birth weight in group A, while the same were only 4 (3.33%) in group B, which was statistically significant (p=0.001, RR=1.98). Poor Apgar score of < or = 7 at 1 minute was observed in 6 (4%) and at 5 min was observed in 5 (3.33%), while none of the neonates in group B was born with Apgar score of less < or = 7 at 1 or 5 minute (p=0.036, RR=1.83; p=0.068, tR=1.82 respectively). Meconium aspiration syndrome was observed in 7 (4.3%) cases in group A, and 2 (1.66%) in group B, which was statistically insignificant. Complication rate among the neonates was statistically not significant between the two groups.
  
  
  CONCLUSIONS
  Perinatal mortality was twice as high in high risk group compared to low risk group. However, the complications in the neonates were statistically insignificant between the two groups.
authors: Department of Obstetrics and Gynaecology, Hamdard University Hospital, Karachi. drnzareen@gmail.com
authors: Nabila
authors: N
authors: Zareen
authors: Sonia
authors: S
authors: Naqvi
authors: Nasreen
authors: N
authors: Majid
authors: Hassan
authors: H
authors: Fatima
mesh_terms: D000328:Adult; D001034:Apgar Score; D005260:Female; D006801:Humans; D007226:Infant Mortality; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D011247:Pregnancy; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk