Earlier the Patients Entering Into Prenatal Care, Higher the Cesarean Rates: Analysis of 17.035 Cases

Pinar Çalış ,Afra Alkan,Fatma Doğa Öcal ,Gürcan Akgül ,İsmail Burak Gültekin

doi:10.21613/gorm.2019.985

Abstract

Objective: To analyze whether the time the patients entering into prenatal care affects the route of delivery, maternal, and fetal outcomes.Study Design: The electronic medical files of 17,035 women who delivered at the same hospital between January 2008 and December 2014, were retrospectively reviewed. Pregnant women were distributed into one of 5 groups (No-prenatal-visit group, Only-pregestational-visit group, First-visit-prior-to-24-weeks-follow-up group, Early-third-trimester-follow-up group, Late-third-trimester-follow-up group) according to the time of their first pregnancy follow-up visit. The route of delivery, maternal anemia, and fetal outcomes were compared among the groups.Results: Pregnant women in the no-prenatal-visit group were younger and showed higher rates of vaginal delivery (56%), term deliveries (90.7%), and postpartum anemia. Those in the first-visit-prior-to-24-weeks group were older and showed higher rates of both primary and secondary cesarean (58%), and higher rates of term deliveries (93.6%) and lower postpartum anemia. Both the primary and secondary cesarean rates were higher in groups with frequent and early follow-up visits than in a no-prenatal-visit group and late-third-trimester-follow-up group (p<0.001).Conclusion: The rates of cesarean deliveries were found to be increased prominently in pregnant women who began antenatal care early in pregnancy with frequent follow-ups.

Highlights

Antenatal care aims to maximize the well-being of both the woman and her fetus through efficient and appropriate screening with preventive and therapeutic procedures
Pregnant women in the no-prenatal-visit group were younger and showed higher rates of vaginal delivery (56%), term deliveries (90.7%), and postpartum anemia. Those in the first-visit-prior-to24-weeks group were older and showed higher rates of both primary and secondary cesarean (58%), and higher rates of term deliveries (93.6%) and lower postpartum anemia. Both the primary and secondary cesarean rates were higher in groups with frequent and early follow-up visits than in a no-prenatal-visit group and late-third-trimester-follow-up group (p
Whereas the frequency of pregnancy follow-up visits was much higher than required among some women, few or no antenatal care despite the accessibility were observed among the others

Summary

Introduction

Antenatal care aims to maximize the well-being of both the woman and her fetus through efficient and appropriate screening with preventive and therapeutic procedures. Various antenatal care programs or recommendations are in use in different countries. Quick Response Code: Access this article online. Considerable differences in the demand for the service of antenatal care exist among pregnant women. Whereas the frequency of pregnancy follow-up visits was much higher than required among some women, few or no antenatal care despite the accessibility were observed among the others. Because of the incidence of maternal anemia, preterm labor, and lowbirth-weight fetuses were reported to be high in pregnancies without antenatal care, every effort is directed toward maximum coverage of the pregnant population [1]

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Conclusion