A STUDY OF RISK FACTORS AND PERINATAL OUTCOME IN PRETERM LABOUR AT TERTIARY CARE HOSPITAL

Abstract

Background- Preterm labour is a common complication that contributes significantly to high perinatal morbidity and mortality. In India, the reported incidence of preterm labour is 10-15 percent. Premature babies are at risk of many immediate and long term complications. Material and Methods- Prospective observational study of various risk factors responsible for preterm labour and the perinatal outcome was done in 125 women, over one year period at tertiary care centre in rural area. Diagnosis of preterm labour was done by ACOG 197 criteria. Results-The incidence of preterm labour was 13.2%. It was observed that 95% women were unbooked cases from poor socio-economic class, staying in a rural area. Fifty percent cases had pregnancy duration of 32 to 34 weeks. Sixty percent cases had some associated risk factor responsible for preterm labour. Antepartum haemorrhage (22.53%) over distension of the uterus (16.90%), hypertension and maternal anaemia were common risk factors. Perinatal mortality in the study group was 42.4%. Early neonatal deaths accounted for 50% of the perinatal mortality. Antepartum haemorrhage, maternal anaemia, hepatitis, obstructed labour, and fetal congenital anomalies were common causes of stillbirths, where as respiratory distress, birth asphyxia and septicaemia were common causes of early neonatal deaths. Neonatal mortality was 100% in the babies with birth weight less than 1000 grams. Neonatal mortality was 63.33% in babies born before 31 weeks of gestation. Conclusion- Early detection of high-risk factors, appropriate intervention, institutional delivery and good neonatal care backup facilities can improve the outcome of preterm labour.