The demographic characteristics and health seeking behaviour of unbooked patients in Irrua specialist teaching hospital

Abstract

Background: The Obstetric outcome of the patients who receive antenatal care and deliver at the Irrua Specialist Teaching Hospital is reasonably satisfactory. Our major challenges arise from unbooked emergencies. The aim of this study was to determine the frequency of unbooked patients in the Irrua Specialist Teaching Hospital, their clinical presentation, their demographic characteristics as well as their obstetric outcome. Methods: A structured proforma was used to collect relevant information over a one-year period from patients' case notes, theatre records and labour ward records. Results: During the study period, unbooked patients constituted 14.7% of all deliveries. They had a higher proportion of teenagers (p<0.0000) and women over 40 years (p<0.0000) when compared to the booked patients. There were also a higher proportion of primigravidas and grandmultiparous women but these did not reach statistical significance. Unbooked patients are also more likely to be single (p<0.001) and polygamous (p<0.0002) when compared to the booked patients. The diagnosis on admission included obstructed labour (18.2%), intrauterine fetal death (14.9%), ante partum haemorrhage (12.4%), post date (12.4%) and eclampsia (8.3%). Eighteen (14.9%) of the unbooked patients had no antenatal care whatsoever, while sixteen 13.2% had been visiting TBAs for some care in pregnancy. Maternal mortality for the unbooked patients was 5/121 (4.1%). There was no maternal death amongst booked patients during the study. Conclusion: The unbooked patients are relatively high- risk patients with some social disadvantage. They have a high maternal mortality.

Nigerian Journal of Medicine Vol. 16 (1) 2007: pp. 65-70