Genitourinary infection and preterm labour: a retrospective study

Sukhwinder Kaur Bajwa,Sushila Goel,Amarjit Kaur,Sudesh Goel,Sukhminderjit Singh Bajwa,Kamaljit Singh

doi:10.4038/sljog.v32i3.3984

Abstract

Objectives: The relationship between genitourinary infections and preterm labour (PTL) is known for ages but still the scenario in developing countries is projecting the same picture as prevalent 2-3 decades earlier. We undertook a study to find out the prevalence of genitourinary infections and PTL with the help of simple laboratory tests so as to enable the various health workers to diagnose and treat them early with the assistance of simple and cost-effective diagnostic methods. Patients and methods: A retrospective study was undertaken in the department of Obstetrics and Gynaecology/ Microbiology, Government Medical College and hospital, Patiala which comprised of 500 cases in PTL between 28-37 weeks of gestation and 500 normal term cases for comparison. All the cases were subjected to microbiological analysis for bacterial (aerobic), fungal and protozoal examination by two high vaginal swabs and urine samples for routine examination, bacteriological examination, culture and antibiotic sensitivity. Statistical analysis was carried out using chi square and student ‘’t’’ test. Results: In the intervention group (Group A) of 500 cases of PTL the frequency of genital tract infection, urinary tract infection (UTI) and combined genitourinary infection (GUI) was 44%, 30% and 16% respectively as compared to 10%, 6% and 0% in the Group B, suggesting a statistically significant relationship of prevalence of genital as well as urinary tract infection in patients with preterm labour. The most common causative organisms of UTI were, Escherichia coli (14%) and Klebsiella pneumoniae (12%), while Gardnella vaginalis (16%) and Candida albicans (14%) were found to be commonly associated with genital tract infection. The number of low birth weight babies was significantly higher in intervention group than in the normal group. Conclusions: Integration of a simple infection screening programme into routine antenatal care may reduce the incidence of preterm labour and improve perinatal outcome especially among the rural population of developing countries. Key words: Preterm labour; genitourinary infections; intrauterine infections; bacterial vaginosis. DOI: <a href="http://dx.doi.org/10.4038/sljog.v32i3.3984">http://dx.doi.org/10.4038/sljog.v32i3.3984</a> SLJOG 2010; 32(3): 57-64

Highlights

Preterm labour (PTL) is defined as ‘’onset of labour with intact membranes after 28 weeks and before 37 weeks of gestation’’
Integration of a simple infection screening programme into routine antenatal care may reduce the incidence of preterm labour and improve perinatal outcome especially among the rural population of developing countries
The present study included 1000 cases which were divided into two clusters: Group A comprised of 500 cases of preterm labour, selected randomly, between 28 weeks to less than 37 weeks of gestation attending the O.P.D./labour ward of Obstetrics and Gynaecology department at Govt

Summary

Introduction

Preterm labour (PTL) is defined as ‘’onset of labour with intact membranes after 28 weeks and before 37 weeks of gestation’’. Maternal infections of urogenital tract are a relatively frequent cause of preterm labour. The overall high rate of incidence of preterm delivery does seem to favour the existence of a strong association between urinary tract infection (UTI) and preterm labour. There is overwhelming evidence that infection is a major cause of spontaneous preterm labour. Numerous studies have shown the relationship between the genitourinary infections and preterm labour but no study has ever documented how to go about its prevention in a large scale at peri pheral l evel 2,3. The simplicity and effectiveness of the model is very essential to ideally decrease the prevalence and to initiate the early intervention so as to prevent preterm labour especially in the rural areas which accounts for 65-70% of the total population of India

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