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A prospective hospital based st~~~· ~·!=s de s i gnArl T:n.
evaluate the effectiveness of ANC - risk sc~ a ening in the
four referral hospitals of Addis Ababa.
The assessment of the effectiveness of the risk
screening was performed by employing ANC card
developed by the Family Health Department, MOH .
A total of 758 mothers completed the study. 385
were high - risks and 373 were low risks.
Among the 385 high risk mother, 232 were parous and
153 were nulliparous. Among the 385 high risk mothers;
pregnancy related diseases 42%, malpresentation and
malposi tion 30 . 6% and age 18.7% and non - pregnancy
related diseases 9.6% were the main risk factors
identified. Fifty six percent were having only one type
of risk factor, 13.3% two and 30.4% three or more risk
factor.
318 (42%) developed bad outcomes. Among these, 225
( 71%) were identified as high risks during antenatal
visit.
Among the listed risk factors, current pregnancy
related diseases (LR+6. 89, PVP 77.8%) , non-pregnancy
related diseases (LR+ 5.53, PVP 73.5%), and malposition
(LR + 4.76, PVP 71 . 2%) were found to have better
discriminator and predictive powers of bad outcomes both
in parous and nulliparous women.
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H~~ight in nulliparous (LR + 3.20, pvp 70 . :<%) a nCl a 'J~
in ooth groups (LR+ 2.80, PVP 67.1%) were found to oe
fairly discriminant and predictive of bad outcome. Bad
obstetrics history (LR+ 1.60, PVP 58.7%) and grand parity
(LR+ 2.0, PVP 67.1%) were found to have less
discriminating and productive capacity.
Presence of 3 or more risk factor (LR + 22.3, PVP
92 . 3) followed by two factors (LR + 3.35, PVP 76.5%) were
also found to have high discrimination and predictive
capacity.
The test performance of the ANC card was sensitivity
63.6%, specificity 70.8% LR + 1.95, PVP 58.4%). This
instrument showed better performance in parous than in
nulliparous.
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" APPEARANCES IN THE MIND ARE OF FOUR KINDS.
THINGS EITHER ARE WHAT THEY APPEAR TO BE ;
OR THEY NEITHER ARE, NOR APPEAR TO BE;
OR THEY ARE, AND DO NOT APPEAR TO BE;
OR THEY ARE NOT, YET APPEAR TO BE.
RIGHTLY TO AIM IN ALL THESE CASES
IS THE WISE HAN'S TASK. "
EPICTETUS 2nd CENTURY AD |
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