Comparing standard primigravidae and low parity women in Tanzania

Abstract

The concept of standard primigravidae is relatively new and has only been used in the past twenty years. It is a tool to assess performance of different obstetric units taking into account the similarities. This study was conducted to determine the proportion of standard primigravid women and compare their pregnancy outcome with women of low parity delivering at Muhimbili National Hospital, Dar es salaam, Tanzania. This is a cross-sectional study carried out from July to December 2007. A total of 775 women were analysed; 296 were standard primigravidae and 479 were women of low parity. The standard primigravid group had a higher emergency caesarean section rate compared to women of low parity. Augmentation of labour and episiotomies were more often given to standard primigravid compared to the low parity group. There were higher rates of prolonged labour and fetal distress than the low parity women. There were lower Apgar scores (LAS) in the primigravid group than in the low parity group. Neonatal unit admissions were more compared to low parity women and the proportion of birth asphyxiated neonates was higher in the standard primigravidae. This study found that standard primigravidae have a slightly higher risk of poor pregnancy outcome compared to low parity women. There is a need for a more aggressive intrapartum monitoring system in this group.