Annual Report of the Department of Health 2010 - Unrwa

OUTCOME OF PREGNANCY
The total number of pregnant women who were expected to deliver during 2010 Agency-wide was 107,062. Active surveillance of the
outcome of pregnancy among those women indicated that 99,763 delivered (93.2%) and 7,100 aborted (6.6%). The outcome of 199
pregnant women (0.2%) who received antenatal care at UNRWA health care facilities remained unreported or unknown as shown in Table
11. This proportion did not change compared with 2009. The percentage of unknown outcomes dropped from 2.8% in 2002 to 0.2% in
2010. The highest proportion of unknown outcomes was found in the West Bank at 1.3%. Although there have been reductions in this Field,
the proportion observed in 2010 it is still considered high and could be attributed to inadequate feedback and follow up of defaulters due
to curfews and restrictions imposed on the movement of clients and staff.
CAESAREAN SECTION
Analysis of the data obtained through the hospital management information system indicated that the caesarean section rate among
women assisted through the UNRWA hospitalization schemes varied widely from one Field to another. It should be noted that these rates
relate to women in the high-risk category and not to all reported deliveries. Caesarean section rate among all reported deliveries during
2010 (19.0%) was higher than in 2009 (17.8%). As shown in Table 12, the highest rate was reported by Syria (38.3%) while the lowest from
the Gaza Strip (12.7%). This could reflect a combination of client preference and prevailing medical practice in hospitals
Table 12 - Caesarean section rate among UNRWA -assisted and all MHIS reported de liveries, 2010
Field Assisted deliveries -high risk (In-patients Reports) All reported deliveries(MHIS)
Total deliveries
Vaginal deliveries rate Caesarean section rate Caesarean section rate
No.
%
No.
%
%
Jordan 13,125 10,127 77.2 2,998 22.8 19.1
Lebanon 2,879 1,810 62.9 1,069 37.1 28.8
Syria 1,882 733 38.9 1,149 61.1 38.3
Gaza Strip
13
13
100
0
0
12.7
West Bank 8,070 6,058 75.1 2,012 24.9 19.8
Agency 25 969 18,741 72.2 7,228 27.8 19.0
DIABETES MELLITUS AND HYPERTENSION DURING PREGNANCY
Agency-wide, the prevalence of diabetes mellitus (DM) during pregnancy in 2010 was stable compared with 2009 (3.2% and 3.1% respectively)
but has increased compared with previous years (1.9% in 2006). This is probably due to the establishment of new cut-off point to
perform the Oral Glucose Tolerance Test (OGTT) for pregnant woman from 110mg/dl to 85mg/dl during the 12th Field Family Health
Officers meeting in 2007. As shown in Table 13, the prevalence of diabetes was 4.8% in West Bank, 4.6% in Lebanon, 4.0% in Jordan,2.7% in
Syria and 2.2% in Gaza Field. Although some Fields achieved the expected prevalence rate of DM of 3-5%, indicating good detection
capacity, others have not. This suggests that further efforts, in particular in the Gaza Field, need to be exerted.
Almost 20% of women with diabetes during pregnancy had pre-existing diabetes, 45.9% had gestational diabetes and
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