OBSTETRIC OUTCOMES

To compare obstetric outcomes in the pregnancy subsequent to still birth with that following live birth in firstpregnancy. Data Source: Medline data base. Study Design: Prospective cohort study. Setting: Ghurki Trust Teaching Hospital Lahore.Materials & Methods: The study included women who delivered a stillbirth between 2005 - 2007(exposed cohort). A group of women with livebirth (unexposed cohort) was matched for delivery within the same year, maternal age (+/- 3 years), parity (+/- 1). In 2009, the charts of thesewomen were examined for subsequent pregnancies. Main outcome measures Maternal and neonatal outcomes in the second pregnancy, preeclampsia, placental abruption, labour induction, instrumental delivery, caesarean delivery, malpresentation, prematurity, low birthweight andstillbirth. Results: The exposed cohort group B (n =50) was at increased risk of preeclampsia (44% versus 28%, p value = 0.001<0.05) andplacental abruption (20% versus 2%) and malpresentation (18% versus 4%). labour induction (20% versus 8%) instrumental delivery(16%versus 8%) and emergency caesarean (40%versus 16%); and prematurity (62%versus 26%, p value = 0.001<0.05), low birthweight(86% versus 54%, p value = 0.000<0.05) and stillbirths (6% versus 2%, p value = 0.489>0.05) of the infant as compared with the unexposedcohort group A (n =50). Conclusions: Majority of women with a previous stillbirth have a live birth in the subsequent pregnancy, they are a highriskgroup with an increased incidence of adverse maternal and neonatal outcomes.