Maternal Complications and Perinatal Outcome in The Booked and Unbooked Cases of Pregnancy at Manipal Teaching Hospital

Introduction: The use of prenatal care prevents maternal complications and perinatal adverse outcomes by early identification of high risk pregnancies, assessment of growth and well being of the fetus, prompt diagnosis and management of complications, with safe delivery. Objectives: This study aims at comparing the obstetrical complications and perinatal outcomes in delivered booked and unbooked mothers to determine the correlation of booking status and maternal and perinatal outcome. Methodology: In this prospective study, 350 patients admitted for delivery at Manipal Teaching Hospital, Pokhara during March 2014 to May 2015 were included. Antenatal complications of the mothers, postnatal complications, neonatal outcome and the mode of delivery were compared amongst the booked and unbooked cases. Results: There was an increased prevalence of preeclampsia (6.3% in unbooked vs. 1.6% in booked); eclampsia (2.5% in unbooked vs. nil in booked); antepartum haemorrhage (5.06% in unbooked vs. 2.1% in booked); Preterm premature rupture of membrane (5.1% in unbooked vs. 2.1% in booked); Rh-isoimmunization (06% in unbooked vs. nil in booked); Intrauterine growth restriction (5.7% in unbooked vs. 3.6% in booked ); and Intrauterine fetal death (7.6% in unbooked vs. 0.5% in booked) in unbooked mothers as compared to booked mothers. The unbooked mothers were prone to postpartum hemorrhage (6.9% vs 2.6% in booked mothers). Assisted breech delivery and ventouse delivery were recorded higher in unbooked cases than in booked case (3.2% vs. 0.5% and 3.8% vs. 3.1% respectively). Conclusion: The poorer maternal and fetal outcome in unbooked cases in comparison to booked cases can be reduced with the best utilization of the prenatal care.