Management of preterm labour In Sohag University hospital: A clinical audit

Abstract

Objective : Auditing the current management of preterm labor in department of Obstetrics and Gynaecology, Sohag University hospital against RCOG recommendations ,Identifying the gap between the current practice and ideal practice and Setting recommendations for filling the gap(if present) to improve neonatal and maternal out comes. Methods : This is an observational study which was conducted at Sohag University hospital durin the period from 1 march 2017 to 31 December 2017. All patients with preterm birth who admitted to Sohag university hospital during the study period were included into the study and their data were recorded in a special check list sheet. IBM-SPSS ( version 24) was used for statistical data analysis. Results : The mean age of our studied group was 26.01±5.15 and 81.1 % of them were rural,48 cases had scarred uterus due to mostly previous caesarean section, while the other 79 cases had non scarred uterus. Also, a little more than half of our cases (66 cases, 52%) .UTI were the only indication for the use of antibiotics .Antibiotics not used for prophylactic in management of preterm birth in our study which is recommended by RCOG .Vaginal swab for oncofetal fibronictine or GBS/vaginal infection were not done as it is not accepted in our department which is against RCOG recommendation .Tocolysis failed in 12 cases out of the 15 multiple pregnancy cases, with a significant difference from the failure rate among singleton pregnancy women .As regard RCOG recomendatins : There is insufficient evidence for any firm conclusions about whether or not tocolysis leads to any benefit in preterm labour in multiple pregnancy. Conclusion : The use of Mgso4 as IV tocolytic drug in our hospital play effective role in prevention of preterm labour and giving the chance for receving the dexamethasone but we need to modyfiy our strategy and using other tocolytic drugs as Ca channel blocker as recommended