AFJOG

African Journal of Obstetrics and Gynaecology | Volume 3 | Issue 2 | 2025 | 29 ORIGINAL RESEARCH African Journal of Obstetrics and Gynaecology | Volume 3 | Issue 2 | 2025 | The impact of the Covid -19 pandemic on Obstetric care in a resource limited setting: A 12- month retrospective chart review Second trimester 603 52.1 478 53.3 0.69 Third trimester 102 8.8 99 11.0 0.47 Unbooked 12 1.1 0.0 0.0 - Total 1157 100.0 896 100.0 Parity Primigravidae 291 25.2 291 31.7 0.08 2 to 4 788 68.1 598 65.1 0.24 Grand multipara 78 6.7 30 3.3 0.50 Total 1157 100.0 919 100.0 HIV Status Reactive 404 34.9 284 31.0 0.29 Non-reactive 753 65.1 633 69.0 0.12 Total 1157 100.0 917 100.0 HIV Suppressed Yes 305 77.4 204 76.1 0.73 No 89 22.6 64 23.9 0.85 Total 394 100.0 268 100.0 Routine Visits <5 294 25.4 266 29.9 0.23 ≥5 863 74.6 625 70.1 0.05 Total 1157 100.0 891 100.0 Defaulted Visits ≤2 1096 94.7 226 93.4 0.44 >2 61 5.3 16 6.6 0.84 Total 1157 100.0 242 100.0 Rescheduled Visits ≤2 1099 95.0 308 93.9 0.44 >2 58 5.0 20 6.1 0.85 Total 1157 100.0 328 100.0 ≤    Most of the deliveries were caesarean deliveries before (n=942, 81.4%) and during (n=707, 76.9%) the pandemic, with emergency deliveries being most frequently conducted before (n=854, 73.8%) and during (n=517, 71.9%) COVID-19. Most deliveries were not because of induction either before (n=856, 74.0%) or during (n=687, 74.8%) the pandemic. Over a third of all the deliveries occurred at the gestational age of 38-40 weeks before (n=449, 38.8%) and during (n=343, 37.3%) the pandemic (Table 3). Table 3: Delivery History of mothers attending Grey's Hospital before (1 March 2019 – 29 February 2020) and during (1 March 2020 – 28 February 2021) the COVID-19 pandemic Pre-Covid Peri-Covid P- Value a Frequency (n) Percentage (%) Frequency (n) Percentage (%) Mode of Delivery Normal vaginal delivery 215 18.6 212 23.1 0.25 Caesarean section 942 81.4 707 76.9 0.03 Total 1157 100.0 919 100.0 Type of Delivery Emergency 854 73.8 517 71.9 0.44 Elective 303 26.2 202 28.1 0.64 Total 1157 100.0 719 100.0 Induction of Labour Yes 301 26.0 232 25.2 0.83 No 856 74.0 687 74.8 0.72 Total 1157 100.0 919 100.0 Gestation on Delivery (weeks) <26 29 2.5 28 3.0 0.91 26-32 165 14.3 126 13.7 0.88 33-37 391 33.8 326 35.5 0.63 38-40 449 38.8 343 37.3 0.67 >40 123 10.6 96 10.4 0.96 Total 1157 100.0 919 100.0 ≤ Neonatal Outcomes The stillbirths before (n=71, 6.1%) and during (n=76, 8.4%) the pandemic, highlighted a 6.5% increase in the pandemic period. During both time periods, the most common type of stillbirth was macerated (n=51, 71.8%) and (n=45, 60.0%) respectively. Majority of the neonates had an APGAR score ranging from 7-10 before (n=1043, 96.0%) and during (n=845, 94.6%) the pandemic. The most common birthweight was 2501 to 3999 grams before (n=473, 40.9%) and during (n=515, 52.4%) the pandemic. Most of the neonates were not admitted into ICU either before (n=723, 62.5%) or during (n=717, 73.0%) the pandemic (Table 4). Table 4: Neonatal outcomes of neonates born to mothers attending Grey's Hospital before (1 March 2019 – 29 February 2020) and during (1 March 2020 – 28 February 2021) the COVID-19 pandemic Pre-Covid Peri-Covid P- Value a Frequency (n) Percentage (%) Frequency (n) Percentage (%) Stillbirth Yes 71 6.1 76 8.4 0.59 No 1086 93.9 834 91.6 0.05 Total 1157 100.0 910 100.0 Stillbirth (Yes) Macerated 51 71.8 45 60.0 0.22 Fresh 20 28.2 30 40.0 0.39 Total 71 100.0 75 100.0 APGAR Score 1 to 6 43 4.0 48 5.4 0.75 7 to 10 1043 96.0 845 94.6 0.15 Total 1086 100.0 893 100.0 Birthweight (grams) <500 100 8.6 27 2.7 0.30 500 to 999 72 6.2 45 4.6 0.71 1000 to 1499 96 8.3 91 9.3 0.81 1500 to 1999 164 14.2 103 10.5 0.38 2000 to 2500 201 17.4 181 18.4 0.80 2501 to 3999 473 40.9 515 52.4 <0.001