A prospective study of risk factors and feto-maternal outcome of preterm labor in OG department of tertiary care centre of South Gujarat
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20231557Keywords:
Preterm labor, Labor arrest, PrematurityAbstract
Background: Every year globally, an estimated 15 million babies are born preterm and this number is rising over major parts of the world. Severe morbidity is common in neonates born before 32-34 weeks of gestation. Management of prematurity is a team approach by the obstetrician and the pediatrician.
Methods: This prospective observational study was conducted in the Department of Obstetrics and Gynecology, NCH, Surat from October 2019 to October 2020. 120 consenting consecutive subjects fulfilling inclusion criteria were enrolled.
Results: The most common risk factor for preterm labor in my study was PPROM (premature rupture of membranes). 27% subjects were diagnosed with threatened preterm labor. 22% subjects delivered preterm due to advanced labor. Labor arrest with tocolytic drug nifedipine was attempted in 30 subjects without any complications, which was successful in 19 subjects. The most common maternal complication in preterm labor was postpartum hemorrhage. All neonates were admitted to NICU, amongst them 45 developed complications. The most common complication in preterm neonates was respiratory distress. The rate of early neonatal death was 6.6%.
Conclusions: Inspite of advances in antenatal care and neonatal services, preterm birth remains a burden to families. Strengthening of referral systems to make sure that high risk patients are managed at tertiary care centers with NICU facilities will improve the neonatal outcome.
References
Beck S, Wojdyla D, Say L, Betran AP, Merialdi M, Requejo JH, et al. The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity. Bull World Health Organ. 2010;88(1):31-8.
Blencowe H, Cousens S, Oestergaard MZ, Chou D, Moller AB, Narwal R, et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet. 2012;379(9832):2162-72.
Perin J, Mulick A, Yeung D, Villavicencio F, Lopez G, Strong KL, et al. Global, regional, and national causes of under-5 mortality in 2000-19: an updated systematic analysis with implications for the Sustainable Development Goals. Lancet Child Adolesc Health. 2022;6(2):106-15.
Berghella V. Universal cervical length screening for prediction and prevention of preterm birth. Obstet Gynecol Surv. 2012;67(10):653-8.
Philip T, Thomas P. A prospective study on neonatal outcome of preterm births and associated f actors in a South Indian tertiary hospital setting. Int J Reprod Contracept Obstet Gynecol. 2018;7:4827-32.
Nungsangtemjen, Mahajan K, Singh MR, Mahongnao Y, Momin DG, Subba T. Fetomaternal outcome in preterm labour. Int J Reprod Contracept Obstet Gynecol. 2021;10:2362-7.
Fernandes SF, Chandra S. A study of risk factors for preterm labour. Int J Reprod Contracep Obstet Gynaecol. 2015;4(5):1306-12.
Hawkins JS, Wells CE, Casey BM, McIntire DD, Leveno KJ. Nifedipine for Acute Tocolysis of Preterm Labor: A Placebo-Controlled Randomized Trial. Obstet Gynecol. 2021;138(1):73-8.
Hangekar P, Karale A, Risbud N. Our experience of nifedipine as a tocolytic agent in preterm labor (24 weeks to 36 weeks 6 days). Int J Reprod Contracept Obstet Gynecol. 2017;6:636-9.
Singh J, Kanti V, Verma V. Study of fetomaternal outcome in cases of premature rupture of membrane at tertiary care rural institute of Western Uttar Pradesh, India. Int J Reprod Contracept Obstet Gynecol. 2020;9:77-81.
Garg S, Kaur T, Saran AS, Yadav M. A study of etiology and outcome of preterm birth at a tertiary care centre. Int J Reprod Contracept Obstet Gynaecol. 2017;6(10):4488-91.
Chauhan N, Purohit RC, Rawat U. Analysis of Etiology and Outcome of Preterm Labour in Tertiary Health Centre of Uttarakhand. Sch J Applied Medical Sci. 2016;4(3):740-3.
Haas DM, Benjamin T, Sawyer R, Quinney SK. Short-term tocolytics for preterm delivery - current perspectives. Int J Womens Health. 2014;6:343-9.
Flenady V, Wojcieszek AM, Papatsonis DN, Stock OM, Murray L, Jardine LA, et al. Calcium channel blockers for inhibiting preterm labour and birth. Cochrane Database Syst Rev. 2014;2014(6):CD002255.
