Anti natal attention is one of the of import wellness services provided by ministry of wellness for long clip. It is provided by primary attention centres which are distributed along the sultanate. In add-on, secondary and third attention centres are lending to this service by following up complicated instances and those with co-morbid conditions like bosom disease and diabetes mellitus. Pregnant ladies are provided booking green card for follow up boulder clay bringing.
Pregnancy is physiological procedure that is associated with some conditions and affected by others like anaemia, diabetes and fleshiness ( 1-6 ) . These status are common in our state ( 7 ) . Besides the result of the gestation is affected by other factors like grade of blood kinship and familial diseases like reaping hook cell anaemia and thalassaemia which are besides common. ( 8,9 ) .
The result of the gestation can be improved by go toing pre matrimonial guidance and pre construct guidance which are besides provided by primary attention centres. So our purpose is to place some ANC jobs in the community and seek to undertake them earlier e.g. Anemia, blood kinship, prenuptial and prepossession guidance by analysing the information given at ANC booking collected at third infirmary ( khoula infirmary ) in Muscat, Oman
Our survey came up with a batch of consequences that we can utilize them to better the prenatal attention. It is demoing that more than 2/3rd of the clients are in their 3rd decennaries and about 1/4th are in 4th decennary. Merely 2 % are above 40 old ages and 4 % are below 20 old ages. Besides the hubbies are chiefly distributed in 3rd and 4th decennaries with similar per centum in each decennary. Around 61 % of the clients complete their secondary school, 11 % are holding advanced instruction and merely 6 % are illiterate ( see fig. ( ) . Besides merely 27 % of them are employers compared to 88 % of their hubbies are employers. Most of our clients presented for their engagement before 13 hebdomads of gestation with per centum of 67 % and 14 % presented before 28 hebdomads of gestation. Sing past medical history, 13 clients claimed to hold including 6 holding diabetes and 3 holding high blood pressure but bulk of them holding household history of diabetes, high blood pressure and cardiovascular disease 48, 30 and 7 patients severally. Besides more than half of the clients are holding unnatural organic structure mass index ( BMI ) and merely 42 % holding normal BMI and 11 % holding low BMI. Around have of patients are related and half of these are holding foremost degree blood kinship. On the other manus, merely 5 % had prenuptial guidance and 8 % had pre construct guidance. About 2/3rd did non utilize contraceptive method before their gestation and most of those who used contraceptive method they have used other traditional contraceptive method followed by injection and so combined unwritten preventives, 11, 8 and 7 patients severally. Merely 1/4th of our patients did non be after their gestation and 13 % became pregnant while utilizing contraceptive method. Most of the clients are either gravida I or holding gravid less than 5, 44 and 41 clients severally. 30 clients reported old gestational complications including 23 maternal, 16 fetal and 9 combined complications.those who have aneima ( hemoglobin & A ; lt ; 11 ) at booking histories for 26 % of the entire sample.
The bi-variant analysis besides demoing some of import consequences. First, there is association between gestational age at engagement and both business and degree of instruction but it is non important i.e. employers and those holding high degree of instruction nowadays earlier with ( Fisher ‘s exact = 0.166 ) and ( 0.750 ) severally. There is important association between degree of instruction and para, i.e platinum with higher degree of instruction holding low para with ( Fisher ‘s exact =0.009 ) . Besides this survey is demoing that there is important association between figure of para and degree of haemoglobin and old gestational complications with ( Pr = 0.004 and Fisher ‘s exact = 0.000 ) severally. i.e higher para is associated with old gestational complications and low haemoglobin. However there is no association between para and high blood pressure. We can besides reason that there is non-significant association between fleshiness and each of old cesarean subdivision, diabetes mellitus and high blood pressure with ( Fisher ‘s exact = 0.149, 0.423 and 0.606 ) severally.
As we saw in the consequences that bulk of the patient are in their 3rd and 4th decennaries severally. It non surprising as we know that Oman is one of the developing states and is holding pyramidic distribution of its population and bulk of them are immature. So as effects, we are seeing that 44 % of the clients are primigravida and 41 % are holding gravida between 2 and 5 which besides can be related to patients & A ; acirc ; ˆ™ business position every bit good. . Besides the fact that 4 % of our patient are younger than 20 old ages, can be explained by first, procedure of instruction and we saw that around 2/3rd of our patient completed secondary school and normally by age of 18 old ages. Second, increased consciousness among the population which is besides can be contributed to wellness instruction provided by ministry of wellness. Third, employment position, although merely around 1/4th of our patients are employed. besides can be explained by complexness of life, that is the males are now acquiring more troubles to acquire married in early age, they have to analyze and so to work and eventually to afford everything in order to hold a household. We besides see about 6 % of our patient are illiterate, this is high figure despite the availabity of free instruction.
The bulk of patients hubbies are working and this is traveling with world here in our state that is the hubbies are working outside and the female parents are taking attention of their houses and kids. As we mentioned that bulk of the clients presented for booking earlier 13 hebdomads of age, there is non-significant association with both degree of instruction and position of employment i.e. employers and educated female parents are showing earlier for booking. This all together can be related to increase consciousness of importance of prenatal attention and follow up and close propinquity of primary wellness attention centres.
As Medical status can impact the gestation, we noticed that 6 % of our clients are holding DM and 3 % holding high blood pressure. This is low compared to the prevalence of these conditions in general population which is 11.6 and 33. ( 7 ) this can be explained by low sample size and larger size is needed to demo such prevalence and because of immature population in our sample.. On the other manus, we noticed a batch of patients are holding household history of diabetes, high blood pressure and cardiovascular disease. Despite the high prevalence of familial diseases like reaping hook cell anaemia, thalassaemia, ( 8,9 ) merely really few patients are go toing pre-marital and pre construct guidance. Besides, half of them are holding blood kinship and 1/4th are holding 1st degree blood kinship. So these are some of the jobs that need a batch of attempts to be tackled in order to hold healthy persons and to avoid passing a batch of moneys in handling such conditions. This can be done through increasing the consciousness of such guidance, promote people to go to prenuptial guidance. Besides pre-conception guidance is of import to place patients who are at high hazard of acquiring gestation, acquire control of their medical conditions if they have like diabetes, high blood pressure, epilepsy and bronchial asthma and supply addendums like folic acid and if anaemic they need ferric sulfate.
Sing contraceptive method, we know that ministry of wellness are making great occupation in supplying this service in primary attention centres. In 1994 and prior to get downing birth spacing in Oman, the prophylactic prevalence rate was of 12.7 % and in 1995, this prevalence increased to 28 % . ( 10 ) But in our survey less than 1/3rd of the clients have used contraceptive method before their gestation. This can be due to the undermentioned grounds. First, 44 % are primigravida.second, deficiency of consciousness. Third, the clients may experience shy in describing contraceptive method usage and methods to the nurses while acquiring the green cards. Besides 11 % coverage usage of other traditional methods of contraceptive method, which is the frequent method, used in our sample and for this ground we are seeing the higher failure rate of 13 % .
The Numberss of old complications are high in our sample and it is significantly associated with figure of para, the higher the para means higher rate of complications. Besides it is known that most of the gestational complications are associated with organic structure mass index. ( 1-6 ) this what we found in our he-man, that there is non-significant association between BMI and old cesarean subdivision ( CS ) , so AS BMI increase the patient is more likely to hold CS which besides found in another surveies. ( 2,3,5,6 ) as we see in the consequences, around half of the sample patients are holding high BMI, so this will set them at hazard of complications. On the other manus there are patient with low BMI and besides this will them under the hazard. So malnutrition is another job in our state that should be tackled. Besides the bi-variant analysis is demoing that BMI is non-significantly associated with high blood pressure and diabetes mellitus. So as BMI increase the hazard of holding high blood pressure and diabetes besides increase.
Anemia in our sample is about 26 % which is low compared to 2006 index ( 11 ) and compared to another survey done at sharqia part ( 12 ) . Besides we noticed that there is important association between anaemia and figure of para i.e. lady with higher figure of para is more likely to hold anaemia. This expected physiological response, because the maternal organic structure is ever fring and in demands for Fe as consequence of frequent gestation, blood loss during deliver and increase demand during breastfeeding.
Our survey has several restrictions. First, little sample size and that is because the period of informations aggregation was short. 2nd, it is done in third attention where many complicated instances are referred. Third, the random choice of the patient was non computing machine based.
Form the survey ; we noticed some common jobs which need to be tackled like malnutrition, low contraceptive method usage, high blood kinship rate, illiteracy and anaemia. Besides we can reason that there is important association between figure of para and all of degree of instruction, anaemia and old complications.