Abstract :
Background: To determine the incidence of preterm labour and also to determine the incidence and various cause of Morbidity and Mortality in the perinatal period.
Materials and Methods: A prospective study of patients in preterm labour (delivered > 28 weeks and prior to 37 completed weeks) admitted to the obstetrics department of JSS Hospital Mysore Karnataka.
Which is tertiary teaching hospital. The study was conducted between February 2012 to January 2014.
Total number of deliveries during the period were 3209 out of which the number of preterm deliveries were 241 which fulfilled our study criteria. Immediately. Following delivery, the following features of baby noted like Sex, weight, APGAR score at 1 and 5-minute, immediate complications, congenital Anomaly, birth injury, gestational age, as assessed by the paediatrician based on modified Ballard scoring. Babies and mother followed up for a period of 7 days. Baby examined for the detection of any complication which were managed accordingly.
During the study the various risk facters associated with preterm labour were also determined in detail and the correlation of the risk factors to antenatal care, maternal age, parity, presentation and lie, mode of delivery, indication of caesarean sections was studied in detail. So, this study we studied the behavioural pattern of the mother and baby towards preterm labour in detail. The data collected as mentioned above were analysed using appropriate statistical methods.
Results: The total number of preterm deliveries were 241 out of the total number of 3269 deliveries in the period of 2 years of the study. Therefore, the incidence of preterm labour was 7.4%. Out of which the total number of preterm spontaneous labour cases were180 (74.7%) and total number of elective preterm delivery were 61 (25.3%). The total number of mortalities during the perinatal period was 82 which accounts of perinatal mortality of 30%. Out of which the total number of stillbirths were 28 (34%) and total number of early neonatal deaths were 54 (66%).
Conclusions: To conclude it was seen that preterm labour was associated with high occurrence of perinatal morbidity and mortality. The main causes were found due to birth asphyxia, respiratory distress syndrome and septicaemia. Preterm labour was more common in primigravida with preterm premature rupture of membrane as triggering factors. Preterm babies were born with number of physiological handicaps and thus predisposed to a large number of pathological conditions which needs anticipation and prompt treatment.
Thus, timely identification of the risk factors and prompt treatment would help to bring down the incidence of preterm labour and hence its perinatal mishap. And lastly improvement of health care services and good neonatal intensive care unit are the cornerstone in the management of preterm births.
Keyword :
Perinatal morbidity and mortality, Preterm delivery.