scholarly journals Risk Factors and Outcome of Preterm Labour in Tertiary Health Centre

2020 ◽  
Vol 32 (2) ◽  
pp. 90-93
Author(s):  
Mst Afroza Khanum ◽  
Salma Lavereen ◽  
Moniruzzaman ◽  
Romana

Background: Currently preterm labour is one of the most challenging problems confronting the obstetricians and perinatologists. This unfortunate episode accounts for 50-75% of the perinatal mortality. Methods: A cross sectional study was conducted on 210 pregnant women with preterm labour admitted in Monno Medical College Hospital, Manikganj from June 2014 to December 2015, to study the causes and outcome of preterm birth in Tertiary health centre of Manikganj. Results: Occurence of preterm birth was 13.82%; 47.14% occured between 34-37 weeks of gestation; 33.80% occured 31-33 weeks of gestation and occurred in 28-30 weeks 19.04%. About 22% patients presenting with preterm labour had a past history of abortions and 14.3% had a history of preterm delivery. Premature rupture of membranes was found to be the most common risk factor related with preterm labour in the present pregnancy. Genitourinary tract infection was the next important risk factor of preterm labour; 24.8% (86) patients had either vaginal infection (19.5%) or urinary infection (21.4%) or both. Another important risk factor identified in this study was antepartum haemorrage which was cause in 11.4 % cases. Preterm babies commonly suffered from various complications like jaundice (32.1%), respiratory distress syndrome (22.6%), asphyxia (13.5%), sepsis, hypoglycemia and coagulopathy. Conclusion: Most of the preterm births occured between 34-37 weeks of gestation. Most common risk factors of preterm births are history of abortion and preterm delivery in previous pregnancy; PROM UTI vaginal infection, PIH and APH in correct pregnancy. Newborn jaundice, RDS and birth asphyxia are the common neonatal morbidity in preterm labour. Identifying risk factors to prevent the onset of preterm labour and advanced neonatal care unit can help decrease neonatal morbidity and mortality. Bangladesh J Obstet Gynaecol, 2017; Vol. 32(2) : 90-93

Author(s):  
Shehla Jamal ◽  
Ruchi Srivastava

Background: Preterm birth is the leading cause of perinatal morbidity and mortality. The incidence of preterm birth in India is 7-9%, and the rates are constantly rising. The main cited reasons for this trend are increasing indicated preterm births and rising rates of artificially conceived pregnancies. Major causes for indicated preterm births are hypertensive disorders of pregnancy, foetal growth restriction, antepartum haemorrhage and PPROM. Risk factors for spontaneous preterm birth include obstetrical complications like multifetal gestation, malpresentations and infections, poor antenatal care, having history of previous preterm delivery, and history of bleeding in the index pregnancy.Methods: This is a retrospective analytical study, done in the department of Obstetrics and Gynecology over a period of two years (January 2015-December 2016). All singleton preterm live births were included in the study. The records of all the included patients were studied from the medical records department of the hospital, after obtaining permission for the same. The results were analysed and obtained by percentage method.Results: A total of 2564 pregnancies were analysed in present study. The number of preterm deliveries was 436 in two years. Out of 2564, the number of live births was 2365, making an incidence of 18.4%. Maximum preterm deliveries were observed in the teenage group (27%) and elderly gravidas (23.9%), both the groups falling into high risk categories for preterm birth. Multiparity was an independent risk factor observed in our study and was found to be associated with 47.5% cases. Level of antenatal care received was also directly related to the number of preterm deliveries. As high as 58.4% of the females landed into preterm birth, who never sought antenatal care, the commonest risk factor for preterm birth was PPROM (26.6%) followed by hypertensive disorders of pregnancy (18.6%). We observed a labor induction rate of 23.4% and Caesarean delivery was performed in 146 (33.5%) cases, thus indicating a high induction and caesarean rates in such pregnancies.Conclusions: Preterm birth continues to challenge obstetricians despite much efforts being executed at all levels. Many of the risk factors are identifiable and can be addressed with a specialised antenatal care program. Screening of genitourinary infections and initiation of treatment can cut down the rates. Early referral and NICU equipped institutional delivery should be promoted to prevent neonatal morbidity and mortality.


Author(s):  
Sunaina Singla ◽  
Banashree Das

Background: Aim of the study was to identify risk factors and to assess neonatal mortality and morbidity associated with preterm delivery in patient attending a tertiary care centre in rural Haryana.Methods: This retrospective cohort study was conducted in Shree Guru Gobind Singh Tricentenary Medical College, over a period of one year (January to December). All pre-term deliveries were included in the study. They were followed up from admission till delivery and till discharge from hospital. Various, parameters like maternal age, associated medical disorder, obstetric complications, gestational age, neonatal mortality, need of neonatal intensive care and condition of baby at discharge were analyzed.Results: In the present study, incidence of preterm deliveries was 16.1%. The most common risk factor found to be history of previous abortion (23.6%), preterm premature rupture of membrane (17.1%), Intra-uterine growth restriction (IUGR) with oligohydramnios (10.5%), hypertensive disorder during pregnancy (5.9%), and antepartum hemorrhage (4.6%). But majority of the patient (56.5%) no cause could be identify. Out of total 160 preterm births 3 were still born and 157 live preterm births, and out of which total Neonatal intensive care (NICU) admission were 60. Mortality rate was 100% in neonate weighing less than 1000 gm and 18% in babies weighing less than 2000 gm.Conclusions: The commonest risk factor for preterm delivery is previous history of abortion and adverse perinatal outcome is inversely proportionate to the period of gestation at the time of delivery. All efforts should be made to prolong the pregnancy beyond 34 weeks by identifying and actively managing the risk factors for better neonatal outcome.


Author(s):  
Sapna D. Berry ◽  
Rajeev Sood ◽  
Kalpna Negi ◽  
Naveen Kumar

Background: Preterm labour and preterm deliveries are very challenging obstetric complications. Early identification of risk factors may help identify women at risk for preterm deliveries.Methods: A one-year observational study was conducted in the department of obstetrics and gynecology, IGMC Shimla, Himachal Pradesh from 1st August 2017 to 31st July 2018. All mothers who delivered between 24 to 37 weeks were subjected to a detailed history with respect to age, parity, previous pregnancy outcomes and to identify the presence of any risk factors. A thorough obstetric and systemic examination was done. Parametric and non-parametric test of significance were used to find the association between different quantitative and qualitative variable.Results: Incidence of preterm deliveries was 11.4%. Maximum cases were of age group 25-30 years. 71.7% belonged to lower socio-economic status. 54% cases were seen in multigravida. History of previous abortion was seen in 18.4% and 9.7% had history of preterm deliveries. 12% cases had history of 1st trimester bleeding.  Spontaneous onset of preterm labour was seen in 55.1%. The significant risk factors associated were PIH and genitourinary infections.Conclusions: The risk factors of preterm birth to a large extent can be identified in antenatal period. Adolescent health education including good nutrition, good hygiene, counselling for contraception to reduce unintended pregnancies and birth spacing can lower the preterm birth rate. Better prenatal care, early identification of risk factors and complicated cases, regular follow up and proper management can help us in reducing preterm births.


Author(s):  
Veronika Günther ◽  
Ibrahim Alkatout ◽  
Alexandra Stein ◽  
Nicolai Maass ◽  
Alexander Strauss ◽  
...  

Abstract According to the World Health Organization, smoking is the most important risk factor for adverse pregnancy outcomes in industrialized nations. We aimed to establish how fetal gender and smoking interact with regard to perinatal outcomes, especially preterm delivery. Data from 220,339 singleton pregnancies, obtained from the German Perinatal Survey in Schleswig-Holstein and registered between 2004 and 2017 were analyzed in regard to smoking behavior, fetal gender, and preterm delivery. The rate of preterm births was directly proportional to the women’s consumption of nicotine. The rate of preterm deliveries was 6.8% among nonsmokers, and 13.2% in women who were very heavy smokers (≥22 cigarettes/day). Very heavy smoking (≥22 cigarettes/day) had a marked impact on extremely preterm births (<28 weeks of gestation) and very preterm births (28–31 weeks of gestation). Preterm births increased by 1.2% from heavy smokers to very heavy smokers; the differences between the other groups ranged between 0.1% and 0.4%. Fetal gender also had an impact on preterm birth: male infants were predominant in nearly all groups of women who delivered preterm infants. Smoking during pregnancy and male gender are both risk factors for preterm delivery. Fetal gender should be given greater attention as one of the several risk factors of preterm birth. Due to the high rate of morbidity among preterm infants and enormous costs for the healthcare system, women should be encouraged to cease or at least reduce smoking during pregnancy.


2021 ◽  
Vol 7 (2) ◽  
pp. 36-41
Author(s):  
Ikrama Hassan ◽  
◽  
Surajudeen Bello ◽  
Michael Anazodo ◽  
Abdulmumuni Ahmed Lawal ◽  
...  

Background: Preterm birth has been on the increase globally and accounting for morbidities and mortalities. Preterm delivery referred to the birth of a newborn prior to thirty seven completed gestational weeks. There is dearth of knowledge on the burden of preterm birth in this state. This study therefore determined the burden of preterm deliveries in Nasarawa State, evaluate the risk factors and identify the outcome of such deliveries. Methods: A descriptive cross-sectional study of all preterm delivered from the 1st of January 2014 to the 31st of December 2013 at the Dalhatu Araf Specialist Hospital (DASH) Lafia, General Hospital Akwanga and Medical Centre Mararaba Gurku in the Southern, Northern and Western senatorial zones of Nasarawa State respectively. Data was analyzed using SPSS version 20. Results: The mean age of mothers of preterm in this study is 26.5±5.7 years. More than three-quarter of preterm birth in Nasarawa State were at the DASH Lafia. The prevalence of preterm birth and admissions were 1.5% and 10.8% respectively. One in four of the preterm were either late preterm or extreme preterm. Singleton gestation accounted for 82.1% of the preterm births while 75.6% of such deliveries where through the vaginal mode of deliveries. Risk factors for preterm deliveries were multiple gestation, antepartum haemorrhage (placenta previa), premature rupture of membrane and previous preterm delivery. Deaths among the preterm was 11% in this study. Conclusion: The burden of preterm births in this study is comparable to other centre in same region. Half of the preterm were either late or extreme preterm. Risk factors for preterm deliveries were placenta previa, premature rupture of membrane, multiple gestation and previous preterm child birth. Death was recorded in one out of every nine preterm


2020 ◽  
Vol 8 (6) ◽  
pp. 449-454
Author(s):  
Dr. Prativa Sahoo ◽  
◽  
Dr. Nayan Kumar Patel ◽  
Dr. Ojaswini Patel ◽  
Dr. A.K Panigrahi ◽  
...  

Introduction: Preterm birth, defined as childbirth occurring at less than 37 completed weeks or 259days of gestation since the first day of a woman’s last menstrual period, is one of the leading causesof neonatal morbidity and mortality. Across 184 countries, the rate of preterm birth ranges from 5%to 18% of babies born. Out of 27 million babies born every year (2018 data ) in India, 3.5 millionbabies born are premature. Recent literature review has shown that the use of Progesterone reducesrisk of preterm birth. But there is little information available regarding the role of Progesterone inpreventing preterm labour. Objectives: Primary objective of the study is to find out the incidence ofpreterm labour among pregnant women taking vaginal progesterone. Secondary objective istoassess the safety and efficacy of progesterone in feto-maternal outcome. Methods: This is a crosssectional study where100 prescriptions from IPD of Dept of O&G, VIMSAR, Burla of women who hadrecently undergone labour with singleton gestation and with previous history of preterm labour wereanalysed. Incidence of preterm labour among those taking and not taking vaginal progesterone werecompared. Results: There was decreased incidence of preterm labour as there is prolongation meanGestational age by 9.383 weeks among pregnant women taking vaginal progesterone. Conclusions:In the present study, women taking vaginal progesterone had significantly lowered incidencepreterm birth rate.


2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Nina Jančar ◽  
Barbara Mihevc Ponikvar ◽  
Sonja Tomšič ◽  
Eda Vrtačnik Bokal ◽  
Sara Korošec

The aim of our study was to explore the risk factors for very preterm (gestation under 32 weeks) and moderate preterm birth (gestation weeks 32-36 6/7) in singleton pregnancies in a national retrospective cohort study. We also wanted to establish whether IVF/ICSI is an independent risk factor for preterm birth after adjusting for already known confounders. We used data for 267 718 singleton births from 2002-2015 from the National Perinatal Information System of Slovenia, containing data on woman, pregnancy, birth, the postpartum period, and the neonate for each mother–infant pair. Mode of conception, maternal age, education, BMI, parity, smoking, history of cervical excision procedure, history of hysteroscopic resection of uterine septum, presence of other congenital uterine malformations, bleeding in pregnancy, preeclampsia or HELLP and maternal heart, and pulmonary or renal illness were included in the analyses. Unadjusted OR for very preterm birth after IVF-ICSI was 2.8 and for moderate preterm birth was 1.7. After adjusting for known confounders, the OR was still significantly elevated (1.6 and 1.3, respectively). Risk factors for very preterm birth with OR higher than 2.4 were history of cervical excision procedure, resection of uterine septum, operation or having other congenital uterine malformations, and bleeding in pregnancy. Risk factors for very preterm birth with OR between 1.4 and 2.1 were age >35 years, being underweight or obese, not having professional education, smoking, first birth, preeclampsia/HELLP, and IVF/ICSI. Risk factors for moderate preterm birth with OR higher than 2.4 were history of cold knife conization and other congenital uterine malformations. We found that even after adjustment, IVF/ICSI represents a single risk factor for early and late preterm birth even after adjustment with other risks such as maternal age, smoking, or a history of invasive procedures for either cervical intraepithelial neoplasia or infertility treatment.


2021 ◽  
Vol 15 (1) ◽  
pp. 13-17
Author(s):  
Tanzeela Zafar ◽  
Iram Manzoor ◽  
Fariha Farooq

Background: Pakistan has one of the highest rates of preterm births, nearly 16 for every 100 babies born. Around 4% of these premature babies, are at highest likelihood of death. The objective of this study was to assess association of multiple risk factors with preterm birth in Pakistani women. Patients and methods:  An analytical cross-sectional study was carried out in Obstetrics and Gynecology Department of Akhtar Saeed Trust Hospital and Farooq Hospital, West Wood Branch, Lahore from October 2018 to December 2019. Total 116 pregnant females who gave birth to preterm babies with gestational age between 20-37 weeks were included. Data about patients’ socio-demographic profile, previous obstetric history and current gestational profile was collected using closed ended structured questionnaire. Variables were presented in the form of frequency tables. Chi-square and Fisher exact test were applied to establish association of various risk factors and preterm presentation of patients’ in hospital. A p-value ≤ 0.05 was taken as significant. Results: Out of 116 participants, 49 (42.2%) were aged between 20-25 years, 47 (40.5%) were illiterate. Of the total sample 60 (51.7 %) participants were obese (BMI >30). Eighty-two (70.7%) patients were multigravida and 65 (56.1%) gave the history of previous cesarean section. Significant association was found between preterm birth and multi-parity (p=0.001), previous history of abortion (p=0.000), intrauterine death (p=0.001), infertility (p=0.04), cesarean-section (p=0.000), and inter-pregnancy interval of less than 24 months (p=0.007). Other significant factors associated with preterm labour were urinary tract infections (p=0.001), documented fever more than 101oF (p=0.000), anemia (p=0.000), singleton pregnancy (p=0.000) and cephalic fetal presentation (p=0.002), during current pregnancy. Conclusion: Multi-gravidity, history of abortion, intrauterine death, previous infertility, cesarean-section, inter-pregnancy interval of less than 24 months, UTI, genital tract infection, anemia, singleton pregnancy and cephalic fetal presentation during current pregnancy were observed to be significantly associated with preterm births.


2019 ◽  
Vol 3 (3) ◽  
pp. 16
Author(s):  
Dadier Marrero González ◽  
Silvana Lisbeth Álava Bermúdez ◽  
Karla Zuleyka Lange García

  El parto pretérmino es un problema de salud a nivel mundial. En la medicina perinatal continúa siendo una de las complicaciones más frecuentes, de ahí que la mayor parte de las muertes neonatales ocurren en nacidos prematuros. El objetivo de este estudio fue determinar la relación entre el aborto previo como factor de riesgo para el desarrollo de parto pretérmino en gestantes ingresadas en al área de emergencias y hospitalización del Hospital Básico Jipijapa. Este trabajo se desarrolló como una investigación cualicuantitativa, retrospectiva, descriptiva y transversal. Las características sociodemográficas de las pacientes con antecedentes de abortos previos y parto pretérmino mostraron que las menores de 18 años, casadas, residentes en zonas urbanas y con nivel de instrucción secundaria fueron la mayoría. Se determinó que el aborto previo predominante fue espontáneo, de dos o tres. La edad gestacional del aborto fue menor a 12 semanas, el tiempo entre la ocurrencia del aborto y el embarazo que culminó en un parto pretérmino fue de 6 meses y la complicación del aborto más presentada fue el aborto séptico. La edad gestacional y el peso al nacer de los pretérminos que tuvieron antecedentes maternos de aborto previo, en su mayoría fue mayor a 32 semanas y con un peso superior a los 2 500 gramos.   Palabras clave: Aborto previo, factor de riesgo, parto pretérmino.   Abstract Preterm birth is a global health problem. In perinatal medicine, it continues to be one of the most frequent complications, hence the majority of neonatal deaths occur in premature births. The objective of this study was to determine the relationship between previous abortion as a risk factor for the development of preterm birth in pregnant women admitted to the emergency area and hospitalization of the Jipijapa Basic Hospital. This work was developed as a qualitative-quantitative, retrospective, descriptive and cross-sectional investigation. The sociodemographic characteristics of the patients with a history of previous abortions and preterm delivery showed that those under 18 years of age, married, living in urban areas and with a secondary education level were the majority. It was determined that the predominant previous abortion was spontaneous, of two or three. The gestational age of the abortion was less than 12 weeks, the time between the occurrence of the abortion and the pregnancy that culminated in preterm delivery was 6 months, and the most common complication of the abortion was septic abortion. The gestational age and birth weight of the preterm who had a maternal history of previous abortion, were mostly greater than 32 weeks and with a weight greater than 2 500 grams.   Keywords: Previous abortion, risk factor, preterm delivery.


2017 ◽  
Vol 5 (7) ◽  
pp. 1016-1020 ◽  
Author(s):  
Badriah Ali Alansi ◽  
Hytham Bahaeldin Mukhtar ◽  
Maher Ahmad Alazizi ◽  
Amjad Ahmad Zuiran ◽  
Areej Mohammed AL-Atawi ◽  
...  

AIM: To investigate risk factors for early preterm birth.METHODS AND MATERIAL: A retrospective comparative study was conducted at Tabuk, Kingdom of Saudi Arabia during the period from January to December 2010. Five hundred and ninety-five patient's files and delivery registry logbooks were reviewed, the following information was collected; demographic data, current and past obstetric histories. Then the early and late preterm births were compared for various risk factors. The Statistical Package for Social Sciences (SPSS version 22) was used. The Chi-square and t-test were used to test the statistical significance and a P-value<0.05 considered significant.RESULTS: Prevalence of early preterm birth was found to be 2.5% in our study group. Women at risk for early preterm birth were: primigravidas (33.7% vs. 26.2% for control), P-value 0.039, OR 1.429 and 95% CI 0.982 - 2.079); multiple gestations (87.7% vs. 95.1% for control, P-value 0.002, OR 0.368 and 95% CI 0.196 - 0.688); and patients with a prior history of placental abruption (3.7% vs. 1.0% for control, P-value 0.027, OR3.928 and 95% CI 1.1360 - 13.586).CONCLUSIONS: Current study indicated that early preterm births differed from preterm as a whole; primigravida, multiple gestations and a history of placental abruption are independent risk factors for them.


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