Fetomaternal outcome in preterm labour

Abstract

Background: Preterm birth is the leading cause of infant morbidity and mortality in the world. It affects not only the immediate neonatal period but also affects infancy, childhood and even adulthood. The aim of the study was to ascertain the causes and outcome of preterm labor and delivery and also the neonatal outcome.Methods: A hospital based cross-sectional study was conducted among patients who entered the third trimester of pregnancy and diagnosed as a case of threatened preterm labor or preterm labor from September 2017 to August 2019 in the department of obstetrics & gynaecology in collaboration with department of paediatrics, Regional institute of Medical Sciences, Imphal. Detailed clinical history and socio-demographic profile were recorded in pre-designed proforma. General physical examination and systemic examination and obstetrical examination was carried out for the participants.Results: Out of 918 preterm births 88.9% of neonates between the gestation period 28 weeks and <32 weeks were admitted to NICU. 48.8% of the neonates were having low birth weight. 23.8% of neonates required NICU admission and the most common neonatal complications were sepsis (5.2%), asphyxia (4%), jaundice (4%) and hyaline membrane disease (1.7%). Apgar score significantly improved as the period of gestation increased at 5 minute and 10 minutes (p=0.006 and p<0.001 respectively). The overall mortality among preterm births was 8.1% and only 3.7% neonatal deaths were seen in gestational age 34 weeks to <37 weeks, whereas 24.1% and 22.2% mortality were seen in 32 weeks to <34 weeks and 28 weeks to <32 weeks of gestation (p=<0.001).Conclusions: Preterm infants are at high risk for overall morbidity and mortality compared with term infants. Proper antenatal care, clinical suspicion, early detection and correction of risk factors, institutional delivery and good neonatal care facilities can improve the outcome of preterm labour.