BACKGROUND Preterm labour is one of the most challenging obstetric complications encountered by obstetricians. Preterm delivery affects one in ten births (11%) and even greater in developing countries. In the United States, preterm birth accounts for approximately 2/3 rd of infant deaths. Prematurity is the cause of 80-85% of neonatal morbidity and mortality in developing countries. In India, prematurity is associated with 75% of perinatal mortality. Maternal infections precipitate preterm labour. One of the most important aetiology of preterm labour and preterm premature rupture of membranes is maternal lower genital tract infection and this leads to increased neonatal infections. The objectives of the study were-1) To find out the prevalence of vaginal infection in preterm labour and preterm premature rupture of membranes. 2) To find out the incidence of neonatal sepsis and its relationship with vaginal swab culture in preterm premature rupture of membranes and preterm labour. 3) To identify common organisms in high vaginal swab culture and its antimicrobial sensitivity. MATERIALS AND METHODS This is a prospective observational study conducted for 12 months from October 2016 to October 2017, in the department of Obstetrics and Gynaecology, Government Medical College, Kottayam. In a previous study by Taralekar Vaishali et al, incidence of genital tract infection in preterm labour was about 59%. For the present study, a conservative estimate of 50% is used in sample size calculation and it is n=105. Statistical analysis is done by using SPSS software. RESULTS Out of the 105 subjects included in this study, 74 were diagnosed with preterm premature rupture of membranes (70.5%), and 31 (29.5%) with spontaneous preterm labour. Majority were in the age group of less than 22 years. Regarding gestational age, 61.9% came under late preterm gestation, majority being primigravidae. Of the 20% positive cultures, most common organism isolated was E.coli (8.6%) and prevalence of genital infection in spontaneous labour and preterm premature rupture of membranes were 16.1% and 21.6% respectively. Most of the isolated organisms were resistant to Ampicillin and sensitive to Cephaperazone-Sulbactum. In this study, 34.3% had neonatal sepsis, 51.4% needed neonatal intensive care and 15.2% succumbed to neonatal death. In 21 positive swab cultures, 88% had neonatal sepsis and 47% died during neonatal period. Relation between the birth weight and neonatal sepsis was statistically significant. CONCLUSION Maternal genital tract infection is one of the causes of preterm labour and preterm premature rupture of membranes. The dictum "prevention is better than cure" applies very well to the management of preterm birth.

Transport of seriously ill children to tertiary centres, under controlled conditions has a direct effect on morbidity and mortality. Poor transport is one of the iatrogenic factors and it is a neglected global issue, especially in the developing world, results in significant annual mortality, as we have scarce and inaccessible facilities and under developed communication system. Data including demographic parameters and transport details were recorded in a structured proforma. Most of the babies who are transported are appropriate for gestational age (71%) and remaining are small for gestational age. The incidence of hypothermia in SGA babies was 86% when compare to AGA babies (61%). Whereas the effect of hypoxia and capillary filling time was more in AGA babies (14%) when compare to SGA babies (3%).

Neonatal hyperbilirubinemia is a reflection of liver"s immature excretory pathway for bilirubin and is the most common reason for readmission of neonates in first week of life in current era of postnatal discharge from hospital. Neonatal hyperbilirubinemia is a cause of concern for the parents as well as for the pediatricians. Hyperbilirubinemia was found to be the most common morbidity. Neonates due for phototherapy were evaluated and samples were collected. Total serum bilirubin, Electrolytes and haematological parameters were checked at 0 hours (before starting phototherapy) 24hours and at 48 hours of phototherapy, daily weight checking and duration of phototherapy was noted by the researcher. In Continuous Phototherapy group, 66% were delivered by Normal vaginal delivery and 34% were delivered by LSCS and in intermittent Phototherapy group, 70% were delivered by Normal vaginal delivery and 30% were delivered by LSCS.