Maternal and perinatal outcome in patients with preterm labor pains receiving tocolytic therapy
Keywords:Preterm birth, Gestational age, Threatened abortion, NICU, RDS
Background: The objective of this study was to assess the maternal and neonatal outcomes in patients with preterm labor pains and also to correlate threatened abortion with preterm pains.
Methods: The study conducted was a prospective observational study. 100 cases of preterm labor admitted to JK hospital, Bhopal over a period of 2 years with singleton gestation between 28 to 36+6 weeks were included.
Results: Maximum preterm deliveries were in the late preterm group (80%). Correlation of preterm labor with threatened abortion was not significant (OR=1.03; p>0.05). 42% cases delivered vaginally and 58% by LSCS. Prolongation of pregnancy after tocolytic therapy was upto 12 hours in 35% cases, 12-24 hours in 40% cases and >24 hours in only 15% cases. The most commonly encountered neonatal complication was RDS, 37%, out of which 9% required resuscitation at birth and 8% required ventilator support followed by jaundice in 23%, sepsis in 3% cases and NEC in 4% cases. The association between gestational age and requirement of resuscitation at birth (X2=19.9; p=0.00), need of ventilator (X2=12.6; p=0.002) and neonatal RDS (X2=6.9; p=0.031) was found to be significant.
Conclusions: Preterm births are major obstetric problem that have an extensive impact on neonatal morbidity and mortality.
Norwitz ER, Robinson JN. A systematic approach to the management of preterm labor. Semin Perinatol. 2001;25(4):223-35.
Chawanpaiboon S, Vogel JP, Moller AB, Lumbiganon P, Petzold M, Hogan D, et al. Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysis. Lancet Glob Health. 2019;7(1):37-46.
Zainal H, Dahlui M, Soelar SA, Su TT. Cost of preterm birth during initial hospitalization: a care provider’s perspective. PloS One. 2019;14(6):0211997.
Karnati S, Kollikonda S, Abu-Shaweesh J. Late preterm infants–changing trends and continuing challenges. Int J Pediatr Adolesc Med. 2020;7(1):36-44.
Saraswat L, Bhattacharya S, Maheshwari A, Bhattacharya S. Maternal and perinatal outcome in women with threatened miscarriage in the first trimester: a systematic review. BJOG Int J Obstetr Gynaecol. 2010;117(3):245-57.
Ahmed SR, El-Sammani ME, Al-Sheeha MA, Aitallah AS, Khan FJ, Ahmed SR. Pregnancy outcome in women with threatened miscarriage: a year study. Mater Sociomed. 2012;24(1):26-8.
Jamal S, Srivastava R. A retrospective analytical study of the epidemiology and causes of preterm birth. Int J Reprod Contracept Obstet Gynecol. 2017;6(12):5453-7.
Kuzniewicz MW, Black L, Walsh EM, Li SX, Greenberg M. Outcomes of admissions for preterm labor. AJP Rep. 2017;7(2):106-13.
Sudhir SP, Mishra S. A prospective study of etiology and outcome of preterm labor in a rural medical college. Obg Rev J Obstet Gynecol. 2016;2(4):60-4.
Charitha U. To study the etiology and outcome of preterm labor. RGUHS. 2010.
Akhter G, Rizvi SM, Hussain SI, Ali F, Ali A. Evaluation of perinatal outcome in preterm labor. Int J Current Res Rev. 2015;7(21):66.
Refuerzo JS, Momirova V, Peaceman AM, Sciscione A, Rouse DJ, Caritis SN, et al. Neonatal outcomes in twin pregnancies delivered moderately preterm, late preterm and term. Am J Perinatol. 2010;27(7):537.