EVALUATING PERINATAL OUTCOMES IN HIGH-RISK PREGNANCIES USING THE MODIFIED COOPLAND’S SCORING SYSTEM AT A TERTIARY HOSPITAL

Authors

  • B MARYAM Department of Obstetrics and_Gynaecology, Jinnah Postgraduate Medical Center (JPMC), Pakistan
  • H YASMEEN Department of Obstetrics and_Gynaecology, Jinnah Postgraduate Medical Center (JPMC), Pakistan
  • F ALAM Department of Obstetrics and Gynaecology, Bolan Medical Complex Hospital Quetta, Pakistan
  • S ALAM Department of Pediatric Medicine, Sandeman Provincial Hospital Quetta, Pakistan
  • A MANAF Sandeman Provincial Hospital Quetta, Pakistan
  • M ASIF Department of cardiology Armed Forces Institute Of Cardiology Rawalpindi, Pakistan
  • A SOHAIL 6Department of Medicine, King Edward Medical University Lahore, Pakistan
  • M KHAN Department of cardiology Armed Forces Institute Of Cardiology Rawalpindi, Pakistan
  • Z HUSSAIN Department of cardiology National Institute of Cardiovascular Diseases Karachi, Pakistan
  • Z HUSSAIN Department of cardiology National Institute of Cardiovascular Diseases Karachi, Pakistan
  • A MUSTAFA Bolan University of Medical & Health Sciences Quetta, Pakistan
  • I AHMED Department of Cardiology, Armed Forces Institute of Cardiology Rawalpindi, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2024i1.1177

Keywords:

High-risk pregnancy, perinatal outcomes, Cooplan’s Scoring System, PPH, Cesarean Deliveries, Low birth weight, APGAR score.

Abstract

This study aims to thoroughly assess perinatal mortality rates, Apgar scores, birth weights, and neonatal complications within the first-week post-birth among high-risk pregnancies. Methods: During a prospective cohort study at Jinnah Postgraduate Medical Centre, Karachi, from October 2023 to May 2024, we evaluated outcomes in 664 high-risk pregnant women using systematic random sampling. Participants, with singleton pregnancies of 24 weeks or more gestation, were stratified by risk level. Data included demographic details, socioeconomic status, BMI, and pregnancy history. Maternal outcomes, such as mode of delivery and postpartum haemorrhage requiring transfusion, and perinatal outcomes, including birth weight and APGAR scores, were assessed. Statistical analysis emphasized odds ratios, with p < 0.05 considered significant. Ethical approval was obtained, and all participants provided informed consent. Results: This prospective cohort study at Jinnah Postgraduate Medical Centre from October 2023 to May 2024 involved 664 high-risk pregnant women categorized by standard risk scoring. Participants were predominantly low-risk (65.77%), followed by moderate-risk (19.88%) and high-risk (14.35%). Key findings included increased rates of cesarean sections, postpartum haemorrhage, premature births, low birth weight, adverse APGAR scores, NICU admissions, and perinatal mortality with escalating risk levels. Statistical analyses revealed significant associations and elevated odds ratios for adverse outcomes among higher-risk groups, underscoring the importance of risk assessment in managing maternal and perinatal health outcomes. Conclusion: Our study highlights the urgent importance of identifying and effectively managing high-risk pregnancies. We discovered that these pregnancies are associated with significantly elevated risks of complications such as Cesarean deliveries, postpartum haemorrhage, preterm births, low birth weights, low 5-minute APGAR scores, NICU admissions, and perinatal mortality. Implementing a straightforward, non-invasive risk-scoring system can facilitate early detection of high-risk cases, enabling timely and tailored interventions that can greatly improve outcomes for both mothers and infants.

Downloads

Download data is not yet available.

References

Prajapati AK, Kumar V, Soni K, Singh NP, Jain PK, Ruchi. Prevalence of high-risk pregnancy among pregnant women enrolled under Pradhan Mantri Surakshit Matritva Abhiyan in government health facilities of district Etawah, Uttar Pradesh: A cross-sectional study. J Family Med Prim Care. 2022 May;11(5):1876-1882. doi: 10.4103/jfmpc.jfmpc_1636_21. Epub 2022 May 14. PMID: 35800511; PMCID: PMC9254766.

Khan SJ, Asif M, Aslam S, Khan WJ, Hamza SA. Pakistan's Healthcare System: A Review of Major Challenges and the First Comprehensive Universal Health Coverage Initiative. Cureus. 2023 Sep 4;15(9):e44641. doi: 10.7759/cureus.44641. PMID: 37799252; PMCID: PMC10548490.

Deen J, Von Seidlein L, Clemens JD. Issues and Challenges of Public-Health Research in Developing Countries. Manson's Tropical Infectious Diseases. 2014:40–48.e1. doi: 10.1016/B978-0-7020-5101-2.00006-6. Epub 2013 Oct 21. PMCID: PMC7149969.

Tharwani ZH, Bilal W, Khan HA, Kumar P, Butt MS, Hamdana AH, Essar MY, Nashwan AJ, Habib Z, Marzo RR. Infant & Child Mortality in Pakistan and its Determinants: A Review. Inquiry. 2023 Jan-Dec;60:469580231167024. doi: 10.1177/00469580231167024. PMID: 37085986; PMCID: PMC10126599.

Farrar DS, Pell LG, Muhammad Y, Khan SH, Tanner Z, Bassani DG, et al. (2024) Association of maternal, obstetric, fetal, and neonatal mortality outcomes with Lady Health Worker coverage from a cross-sectional survey of >10,000 households in Gilgit-Baltistan, Pakistan. PLOS Glob Public Health 4(2): e0002693. https://doi.org/10.1371/journal.pgph.0002693

Aziz, A., Saleem, S., Nolen, T.L. et al. Why are the Pakistani maternal, fetal and newborn outcomes so poor compared to other low and middle-income countries?. Reprod Health 17 (Suppl 3), 190 (2020). https://doi.org/10.1186/s12978-020-01023-5

Ali H, Ali A, Mehmood QK, Jalal A, Ali SR. Antenatal Care: Accessibility Issue among Pakhtun Women in Malakand, Pakistan. Isra Med J. 2018; 10(6): 362-366.

Kumari P, Singh M, Sinha S, Ranjan R, Arora P, Rani S, Aggarwal A, Aggarwal K, Gupta S. Preidentification of high-risk pregnancies to improve triaging at the time of admission and management of complications in labour room: a quality improvement initiative. BMJ Open Qual. 2022 Jun;11(Suppl 1):e001718. doi: 10.1136/bmjoq-2021-001718. PMID: 35714981; PMCID: PMC9207917.

Coopland AT, Peddle LJ, Baskett TF, Rollwagen R, Simpson A, Parker E. A simplified antepartum highrisk pregnancy scoring form: statistical analysis of 5459 cases. Can Med Assoc J. 1977;116(9):999- 1001.

Chate SU, Metgud CS. Pregnancy outcome among high-risk pregnant women in the rural area of Belagavi. J Family Med Prim Care. 2022 Aug;11(8):4440-4446. doi: 10.4103/jfmpc.jfmpc_10_22. Epub 2022 Aug 30. PMID: 36353024; PMCID: PMC9638629.

Mohammadi S, Shojaei K, Maraghi E, Motaghi Z. Care Providers' Perspectives on Quality Prenatal Care in High-risk Pregnancies: A Qualitative Study. Int J Community Based Nurs Midwifery. 2023 Apr;11(2):122-134. doi: 10.30476/IJCBNM.2023.97603.2192. PMID: 37114102; PMCID: PMC10126442.

Yuan, H., Ferreira, F.A.F. Sustainable competitive advantage in maternal and child health institutions: a dynamic capability approach. Ann Oper Res (2022). https://doi.org/10.1007/s10479-022-04738-9

Mufti S, Mufti S. Identification of high risk pregnancy by a scoring system and its correlation with perinatal outcome. Indian J Practic Doct. 2008;5:1-7.

Anand B, Mansukhani C, Gujral K, Pradhan M. Importance of developing a new modified high risk pregnancy scoring system. Indian Obstet Gynaecol. 2017;7(1):10-4.

Kaur H, Thakur S. Identification of high risk mothers by a scoring system and its correlation with perinatal outcome. J Obstet Gynecol India. 1994;44(1):361.

Pillai SS, Mohan S. High risk scoring in pregnancy using modified Coopland’s scoring system and its association with perinatal outcome. Int J Reprod Contracept Obstet Gynecol 2021;10:1608-13.

Dutta S and Das KS 1990. Identification of high risk pregnancy by a simple scoring system J Obstet Gynecol India 37:639-642.

Kolluru V, Reddy A. Study of high risk scoring in pregnancy and perinatal outcome. Ind J Obstet Gynecol Res. 2016;3(4):407-9.

Samiya M, Samina M, et al: Original paper identification of high risk pregnancy by a scoring system and its correlation with perinatal outcome. Indian journal for the practising doctor; vol 5: no-1

Harinder Kaur, Seema Thakur et al: Identification of high risk mothers by a scoring system and its correlation with perinatal outcome. J of Obstetrics and Gynaec of India 1994:361-364

Downloads

Published

2024-10-03

How to Cite

MARYAM , B., YASMEEN , H., ALAM , F., ALAM , S., MANAF , A., ASIF , M., SOHAIL , A., KHAN , M., HUSSAIN, Z., HUSSAIN, Z., MUSTAFA , A., & AHMED, . I. (2024). EVALUATING PERINATAL OUTCOMES IN HIGH-RISK PREGNANCIES USING THE MODIFIED COOPLAND’S SCORING SYSTEM AT A TERTIARY HOSPITAL. Biological and Clinical Sciences Research Journal, 2024(1), 1177. https://doi.org/10.54112/bcsrj.v2024i1.1177

Most read articles by the same author(s)

<< < 1 2 3 4 > >>