Evaluation of pregnancy cases under the age of 18 who have consultated to obstetrics and gynecology department outpatient clinics of Karadeniz Teknik Üniversitesi Faculty of Medicine

Evaluation of Pregnancy Cases Under the Age Of 18 Who Have Consultated To Obstetrics and Gynecology Department Outpatient Clinics of Karadeniz Teknik Üniversitesi Faculty of Medicine Introduction and Objective: According to the World Health Organization, adolescent pregnancies, which are defined as the age range of 10-19 years, create an important health problem in our country and in the world. Adolescent pregnancies represent a population of children who become pregnant and give birth in a world where all individuals under the age of 18 are considered children by universal conventions. Adolescent pregnancies are high-risk pregnancies due to increased obstetric complications and are the leading cause of mortality and morbidity in girls. The fact that adolescent pregnancies are a natural consequence of child marriage, which is a common practice in societies, reveals the fact that it is a violation of human rights. In order to combat childhood pregnancies and marriages globally, which is a serious public health and human rights problem that concerns the whole world, it is necessary to create the necessary social awareness and discuss all medical, social and legal aspects. In our study, we evaluated the characteristics of pregnancies under 18 years of age admitted to our hospital; To reach the profile of our region in terms of adolescent pregnancies by evaluating the characteristics of pregnancies under the age of 18 admitted to our hospital through sociodemographic and medical characteristics such as age, pregnancy characteristics (gravida, parity, miscarriage, curettage, living child), gestational age, mode of presentation to the hospital, to reveal the differences that may exist by comparing the characteristics of our region with the literature, to define the situation of these underage mothers within the framework of children's rights, to discuss the issue from different angles with the outputs to be revealed, to increase social awareness and sensitivity and to contribute to the literature. Material and Method: Our study was conducted at Karadeniz Technical University Faculty of Medicine Farabi Hospital and included all pregnant women under the age of 18 years who were admitted to the outpatient clinics of the Department of Obstetrics and Gynecology and the Department of Emergency Medicine in the 7-year period between 01.01.2015-31.12.2021. Our cross-sectional descriptive study was conducted by retrospectively analyzing the medical records of 162 pregnant women under the age of 18 years through the hospital information system. SPSS 15.0 for Windows program was used for statistical analysis. The proportions in the groups were compared with the chi-square test. Alpha significance level was accepted as p˂0.05 Results: Adolescent pregnant women included in our study were evaluated in terms of maternal age, marital status, type of hospital admission (forensic/medical case), gestational week, gravida, parity, maternal medical history, previous fertility history, obstetric complications and mode of pregnancy outcome (NVYD, C/S, complete abortion, curettage). The youngest age of the adolescent pregnant women at the first hospital admission was 14 years and the mean age of the sample was calculated as 16.9±0.9 years. In 82 (50.6%) cases, no information about marital status was recorded. Of the 80 cases for whom marital status information was obtained, 52 (34.5%) were legally married and 28 (17.5%) were single. When we considered the cases as stated in the law, it was observed that 12 pregnant women (42.7%) under the age of 17 (n=46) were registered as married. In the examination, it was determined that the number of adolescent pregnant women who were reported as forensic cases was 45 (28.0%) and 116 (72.0%) cases were recorded as medical admissions. 13 pregnant women under 17 years of age (28.3%) were not recorded as forensic cases. Adolescent pregnant women were most frequently (37.5%) admitted in the second trimester of pregnancy. In terms of maternal and fetal complications, the increase in the rate of maternal complications as age increased, was statistically significant(p=0.023). When we analyzed the termination methods of pregnancies, it was seen that pregnancies under 17 years of age were most frequently terminated by curettage with a rate of 50%, and the most common reason for curettage was court decisions for legal termination of pregnancy. Conclusion: Adolescent pregnancies are considered high-risk pregnancies due to their obstetric complications and fatal outcomes. Adolescent pregnancy is not only a serious public health problem due to the physical, mental and psychological trauma it may cause to the girl child, but also a violation of children's rights as it is a potential barrier to the child's access to education and social life. In our study, we found that there were deficiencies in the reporting of forensic cases for adolescent pregnancies in which no information on civil marriage was entered. Adolescent pregnancies are an issue that should be evaluated forensically in terms of criminalization of the negative effects they cause on the individual and society. Notification to the judicial authorities in case of pregnancy in adolescence is a judicial duty of health personnel. Healthcare workers should be informed and made aware of the fact that criminal sanctions will be imposed if they fail to fulfill their responsibility to report the forensic case. Applicable and effective social, legal and economic policies should be developed to prevent all kinds of factors that predispose and facilitate adolescent pregnancy. In addition, these policies should be supported by decisive control mechanisms and penal sanctions. Key Words: Adolescent Pregnancy, Child Marriage, Civil Code, Forensic Medicine