PERINATAL OUTCOME OF EARLY PRETERM STAGE II IUGR AT TWO HOSPITALS IN ADDIS ABABA: A RETROSPECTIVE CROSS SECTIONAL STUDY

Abstract

Abstract

Background: Intrauterine growth restriction is a common obstetric complication. Based on the severity it is classified into stage 0-IV. Stage II IUGR is defined as ultrasound estimated fetal weight less than 10^th percentile for gestational age with absent end diastolic velocity on umbilical artery Doppler ultrasound. Studies focusing on perinatal outcome of specific class of IUGR are limited.

Objective: The aim of this study is to show the magnitude of stage II IUGR and see the perinatal outcome of early preterm stage II IUGR at two public hospitals in Addis Ababa, Ethiopia.

Method: A retrospective cross sectional study conducted from January 2019 to August 2022. Data was collected from medical records using a structured pre-tested questionnaire. Data was coded, entered and analyzed using SPSS version 25.

Result: There were 49,338 deliveries at the two study hospitals. Of these 192 pregnancies were complicated by stage II IUGR; 151 of which were diagnosed at the early preterm gestational age. The prevalence of stage II IUGR was 0.39% where as the prevalence of early preterm stage II IUGR was 0.3% out of the total deliveries. Preeclampsia was the leading obstetric complication diagnosed in 107 (70.9%) of the cases. Mode of delivery for all of the neonates was by cesarean section and all required NICU admission. The single most common perinatal morbidity was RDS, which accounted for 42 (27.8%) of the cases. Half of the 151 pregnancies diagnosed with early preterm stage II IUGR, 75 (50 %), ended up in perinatal death. Majority of the perinatal losses were during early neaonalal period, 56 % (42/75). Compared to those with birth weight of <1000gm those with birth weight of 1500-2499gm had more than 37 times chance of survival in the perinatal period (AOR=37.67 (7.05, 201.36), p<0.000).

Conclusion and recommendations: The prevalence of stage II IUGR was 0.39% where as the prevalence of early preterm stage II IUGR was 0.3%. Early preterm stage II IUGR was associated with significant perinatal morbidity and mortality. Birth weight was a determinant factor significantly associated with perinatal survival. Antenatal interventions that can help delay the onset of disease may help improve perinatal outcome.

Key terms: IUGR, Stage II IUGR, perinatal death, perinatal outcome.