Assessment of Hobel’s Scoring System in High Risk Pregnancy and Its Correlation with Perinatal Outcome in a Tertiary Care Centre
Journal Title: International Journal of Medical Research Professionals - Year 2018, Vol 4, Issue 5
Abstract
Introduction: The perinatal mortality rate has often been used as an index of the level of development in a community. Awareness of the special vulnerability of the cohort of mothers with ‘high risk factor’ has led to the popular recognition of ‘risk approach’, involving the optimal use of existing MCH services, providing essential obstetrical care for all with early detection of complications and emergency services for those who need it, thus reducing the need for intensive care along with reduction in perinatal mortality. Objective: To assess Hobel’s antenatal/intrapartum risk scoring system in pregnant women in hospital admissions and its correlation with perinatal mortality. Materials & Methods: The present study was carried out on 2050 consecutive deliveries from 1st April 2015 to 31st March 2016 at Department of Obstetrics and Gynecology and Department of Pediatrics, Muzaffarnagar Medical College, Muzaffarnagar. All the pregnant women were interviewed and examined in detail at the onset of labor regarding various bio-socio-economic, physical & family characteristics, history of past and present medical and obstetrical complications. A high risk pregnancy screening system devised by Calvin J Hobel et al (1973) was used as an antenatal and intrapartum predictor of perinatal mortality & morbidity. The patients were divided in low (0-9) and high (≥ 10) risk groups. Finally, neonatal outcome as birth weight, gestational age, one minute and five minute apgar scores, and occurrence of morbidity and/ or mortality was evaluated in relation to this score to judge the validity of this high risk pregnancy screening system in prediction of neonatal mortality and morbidity in our set up. Results: The PNMR (93.66/1000 birth) observed in present study was still at a higher level. Hobel’s high risk scoring system was found to be significant at a cut- off score mark of 10 and 15, the sensitivity being higher at 10. This scoring system was though highly sensitive (96.35% and 90.80% for PNM and NNMB respectively) with only 3.65 and 9.2% inclusion of false negative mothers in low risk group but it was not very specific (98.7, 96.16% for PNM and NNMB respectively) with inclusion of high number of false positive mothers (66.14%, 68.0%), who although grouped as high risk, did not show a significant perinatal mortality or neonatal morbidity. Conclusion: Hobel’s scoring system being a screening test for its application in community is still significant and helpful with a high degree of sensitivity and almost rules out neonatal risk in low risk group of mothers. Hobel’s scoring system is also significantly correlated with other parameters of neonatal morbidity and perinatal mortality viz. gestational age, birth weight, one and five-minute apgar scores.
Authors and Affiliations
Manish Agrawal, Virendra Yadav, Kriti Bhatnagar
Keywords
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- EP ID EP537071
- DOI 10.21276/ijmrp.2018.4.5.052
- Views 194
- Downloads 0
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