Maternal Risk Factors among Pregnant Internally Displaced Person Women in Mardan, Pakistan

Objective: To review the maternal risk factors present among pregnant internally displaced persons (IDP) women living in Mardan District, Khyber Pakhtunkhwa (KPK) province of Pakistan. Study design: Descriptive retrospective study. Methods: The study was conducted at the Mardan Medical Complex, Mardan, from 21st May to 15th June 2009. The medical records of all the pregnant women who were referred from the internally displaced person (IDP) camps located in the Mardan District and the self-referrals of IDPs living outside the camps, presenting at the Mardan Medical Complex were collected retrospectively. The data was tabulated and analyzed using SPSS version 20. The percentages were calculated to determine the frequency of various maternal risk factors demonstrated among the pregnant IDPs. Results: During the study period of 25 days, a total of 27000 female patients presented at the Mardan Medical Complex and among these 1154 were obstetric patients. There were 29 % primigravidas, 53 % multipara and 18 % were grand multipara. The total number of vaginal deliveries performed was 221 (76.2%) and caesarean sections were 68 (23.5 %) and there was one obstetrical hysterectomy (0.3%) performed as a life-saving procedure. More than 34 % of IDP women were admitted for at least one high-risk pregnancy complication. There was one maternal death (0.8%) due to obstructed labour and ruptured uterus of an IDP living outside the camps. Conclusion: This study unmasks the high risk status of pregnant IDP women living inside and outside the camp setting. It is highlighted that strategies must be developed for the provision of appropriate obstetrical care to these displaced women. The lessons learned from this crisis may serve to reduce the maternal mortality rate among the unfortunate IDPs.