Evaluation of Aetiopathogenesis of Spontaneous Preterm Parturition Syndrome: A Cross Sectional Study

Abstract

Abstract Background: Preterm birth is the multifactorial condition of the pregnancy involving the same parturition pathway as term birth but the different outcome in terms of morbidity for both mother and fetus, various pathological process has been identified and need to be evaluated further. Aim: To evaluate the aetiopathogenesis of spontaneous preterm labour by analysis of maternal risk factors and placental abnormalities. Objectives: (a) To study the prevalence of spontaneous pre term labor in tertiary care centre. (b) To identify associated maternal factors both clinical as well as pathological as the probable cause of pre term labor. (c) To examine the placenta for any gross and his to pathological abnormalities associated with spontaneous pre-term labor. Settings and design: This is the cross sectional observational study carried out in a tertiary health care centre over 2 years from October 2019 to october 2021. Materials and methods: A cross sectional observational study consist of 255 pregnant women between the 20 weeks to 36 weeks 6 days of gestation fulfilling the inclusion criteria were selected excluding the women iatrogenically induced for preterm birth. The methodology and relevance of the study were explained to the women and valid informed written consent was recorded. The ethical clearance for the study obtained from ethical review committee of the tertiary care centre. During the study duration, women presenting with preterm labor were observed till delivery whether delivered or not in our tertiary care centre and finally were included in the study. The following data were collected under the heading of age, occupation, height, weight, body mass index, parity, presenting complaints of pain in abdomen per vaginal leak, par vaginal bleed, high grade fever, headache, edema, epigastric pain, blurring of vision, palpitations vomiting, weight gain, gum bleeding breathlessness, burning micturation, increased frequency of micturation, itching over genital region, dark coloured urine also including the co-morbidites such as asthma, anemia, valvular heart disease, diabetes, thyroid disorder and preeclampsia. Detailed physical examination was done, blood pressure was measured with sphygnometer, detailed per abdominal examination done with the use of measuring tape to measure fundal height, abdominal circumference, all fungal grip were palpated, per speculum examination was done to look for per vaginum discharge, per vaginal bleeding, and the high vaginal swab was taken for further evaluation. In per vaginum examination cervical changes were seen like dilatation, effacement, length. The necessary laboratory findings were done includes complete blood count to look for haemoglobin, total leucocyte count, platelet counts, urine microscopic and culture sensitivity was done to analyse the infection. Later, after the delivery the placenta was send and histopathology examination was done. Conclusion: In our study we made an attempt to identify the risk factors and associated factors involved in spontaneous preterm labor. The study able to identify the risk factors which can be potentially used for predicting outcome. Keywords: Spontaneous preterm; Multifactorial.