A Prospective study of etiology and outcome of Preterm Labour in a Rural Medical College

Dr Sunita Sudhir P,Dr Sunita Mishra

doi:10.17511/joog.2016.i04.01

Dr Sunita Sudhir P, Dr Sunita Mishra

Open Access

https://doi.org/10.17511/joog.2016.i04.01

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Abstract

Introduction: Preterm birth is a major problem in developing countries contributing significantly to perinatal mortality. Preventing preterm labor is still a great challenge in modern obstetrics. Every year an estimated 15 million babies are born too early (more than 1 in 10 babies are preterm). 1 million neonates dies each year due to complication of preterm birth. Many who survive face a life time of disability. Aim & Objective: To study the etiological factors and to assess the Neonatal Mortality and Morbidity associated with preterm labor and delivery. Methods: This prospective study was conducted from December 2014 to September 2015 in rural medical college where 107 antenatal women admitted with threatened preterm labor with or without rupture of membranes were followed till delivery and discharge. Gestational age at onset of preterm labor, associated risk factors, response to Tocolytics, Gestational age at delivery, and neonatal outcome were recorded and analysed. Results: Pregnancy Induced Hypertension, Anaemia, Infections, Oligohydramnios, were the commonest causes of preterm deliveries. Neonatal morbidity and mortality was less in steroid covered group. Birth asphyxia, Respiratory Distress Syndrome, Hyaline Membrane Disease were the commonest causes of morbidity. Respiratory Distress Syndrome was significantly reduced in those who were on steroid cover. Conclusion: There is a high incidence of preterm labor and preterm births in our set up. Infection and anaemia are important factors which can be prevented. Prolongation of delivery for 48 hrs by giving Tocolysis for getting the benefit of betamethasone coverage reduces morbidity due to RDS.

Highlights

Preterm birth is a major problem in developing countries contributing significantly to perinatal mortality [1]
In 6 cases pregnancy could be prolonged for a week, in 4 cases pregnancy could be prolonged for 2 weeks, in 6(5.6%) cases pregnancy could be prolonged to the expected date of delivery (EDD)
Delivery on the day of admission was observed in 62 cases (57.94%), out of which 10(10%) cases had preterm Intra Uterine Death (IUD) where termination was indicated, 4(3.73%) cases had spontaneous preterm still birth

Summary

Introduction

Preterm birth is a major problem in developing countries contributing significantly to perinatal mortality [1]. Every year an estimated 15 million babies are born too early (more than 1 in 10 babies are preterm). Million neonates dies each year due to complication of preterm birth. Half of the preterm births are preceded by pre term labor. We need to be aware that Pre Term Labor (PTL) is not a disease, but an event which may result from single or multiple independent or interdependent. As preterm labor causes considerable morbidity and mortality in terms of neonates and mother and no single factor is solely responsible for pre term labor and delivery. This study was aimed at identifying the common factors responsible for pre term labor delivery and its outcome after possible intervention

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