INTRODUCTION:

Determinants of obstetric complications: Maternal age has been indicated to be an important factor in determination of obstetric outcome. Adolescent mothers especially those with 15 years and below appear to be at high risk during childbearing with poor obstetric outcome (1).
Adolescence is a period in which an individual progress from a point of initial appearance of secondary sexual characteristics to that of maturity (2). The individual psychological processes and patterns of identification develop from those of a child to those of an adult with a transition from the state of total social economic dependence to one of relative independence. WHO, defines adolescence as the period ranging from 10 to 19 years of age (3).

Pregnancy in adolescent and obstetric complications: Demographic data indicate that pregnancy in adolescence is more likely associated with being single, having low socioeconomic status and lacking social support systems. Pregnant adolescents are believed to be at high risk for some complications of pregnancy; but, if however, they seek prenatal care early and consistently cooperate with recommendations, the risk is comparable to that for other age groups(4). Clinical data identify a common pattern of late entry to the prenatal care system, failure to return for scheduled appointments and non-compliance with medical and nursing recommendations. As a result of these behaviors, adolescents are at higher risk for pregnancy-related complications, such as preterm labor and delivery, anemia, obstructed labor, hemorrhage and pre-eclampsia and eclampsia. Other complications include abortion, puerperal sepsis, ectopic pregnancy, ruptured uterus and low birth weight babies. These complications are major causes of maternal morbidity and mortality. Under proper and prompt management of these complications, the maternal morbidity and mortality are highly reduced.

Risk of adolescent primigravidae: For the adolescent primigravidae then, because of the anatomical and physiological immaturity of their reproductive organs, together with the socioeconomic status, cultural values and the feeling of being dependent, they are less ready than the older women to have healthy babies (5). Many have poor eating habits, poor quality diet and poor knowledge of the appropriate nutrition and these habits may not change during pregnancy.
Some of the complications are attributed to intra uterine growth retardation leading to small for gestation age. Poor weight gain and physical immaturity also increases the difficulties of delivery (6). However, psychosocial immaturity of the adolescents has contributed because they are less likely to ask for some investigations / measurements as well as poor medication compliance. Lack of antenatal care or poor prenatal care increases the chance of obstetric complications. The younger the mother, the greater the risks of complications for the mother and child.

Problem statement: Obstetric complications are still major problem in our pregnant in our parent women particular to the adolescent ones (7)in Tanzania up to 19.3%of deliveries occur among adolescent women and of these 92% are poverty lack of health education and lack of access to health care services (8) .This study is aiming at finding out what is prevalence of obstetric complications among adolescent primigravidae who delivered at BUGANDO MEDICAL CENTRE.

Rationale of the study: Adolescent pregnancy is a risk pregnancy associated with increase perinatal and maternal morbidity and mortality and is subjected of worldwide concern in Tanzania 26% of adolescents have already begun childbearingReport from Muhimbili National Hospitalshow that up to 19% of deliveries occur among adolescent women and of these 92% are primigravidae(8).Few studies have been done in Tanzania concerning the outcome of adolescent pregnancy but these studies are very old and the information that does not reflect the present situation hence a need of recent study like this one. This study will provide the prevalence adolescent primigravidae obstetric complications in the peripheral city setup of Tanzania.

Research questions: What is the prevalence of obstetric complications among adolescent primigravidae delivered at Bugando Medical Centre?

Main objectives: To determine the prevalence of an obstetric complications and associated factors among adolescent primigravida delivered at BUGANDO MEDICAL CENTRE.

Specific objectives:
To determine the prevalence of obstetrics complication among adolescent primigravidae delivered at BUGANDO MEDICAL CENTRE.
To determine the complications among adolescent primigravidae delivered at BUGANDO MEDICAL CENTRE.
To determine the associated factors of complication among adolescent primigravidae delivered at BUGANDO MEDICAL CENTRE