Management and prognosis of poor prenatal monitoring at the maternity unit of the Ignace Deen teaching hospital-, in Guinea

Abstract

 Introduction: Unmonitored pregnancies present significant maternal and fetal morbidity and mortality. The objective of this study was to assess the maternal-fetal prognosis of unmonitored pregnancies.  Methodology: This was a case-control study conducted from April 1 to September 30, 2023, at the maternity ward of Ignace Deen University Hospital. Women who had given birth and agreed to participate were included. Two groups were formed: unmonitored patients (< 4 ANCs) and well-monitored patients 
(≥ 4 ANCs). Maternal-fetal prognosis was studied. Analysis was performed using SPSS 21.0.  Results: The frequency of poor prenatal follow-up was 16.3%. The mean age was 26 ± 6.01 years (12–46 years). The dominant age group was 20–24 years (29.1% vs 31.4%). The liberal professions 20% vs 19.9% (p = 0.05) and educated women 26.5% vs 15.8% (p = 0.00). Caesarean section was performed in 
32% vs 23.1% (p = 0.05). Poor follow-up was associated with severe preeclampsia (OR = 1.71; p = 0.00), eclampsia (OR = 1.82; p = 0.00), retroplacental hematoma (OR = 1.93; p = 0.00), and anemia (OR = 1.76; p = 0.00). The risk of maternal death was twice as high (0.1% vs. 0.0%). The risk of low birth weight (12.8% vs. 3.1%; OR = 1.81; p = 0.02) and stillbirth (8% vs. 1.2%; OR = 1.88; p = 0.001) was significantly higher.  Conclusion: Lack of prenatal follow-up is associated with high maternal and perinatal morbidity and 
mortality in our department.