ABSTRACT
Background: Congenital anomalies are a major cause of stillbirths and neonatal mortality. The pattern and prevalence of congenital anomalies may vary over time or with geographical location. The aim of this study is to determine the proportion and types of congenital anomalies in live newborns and to study maternal and perinatal risk factors. Methods: This prospective study was conducted over a 1 year period (March 2014 to February 2015) in the department of Pediatrics and Obstetrics/Gynaecology at Patliputra Medical College, Dhanbad, Jharkhand during the period of May 2014 to April 2015. All the live born babies born in this hospital during this period were included. The newborns were examined for the presence of congenital anomalies and mothers were interviewed for socio-demographic variables. Results: During the study period, 8546 babies were born, of which 246 had congenital malformations, making the prevalence 2.19%. Most of the women (57.8%) belonged to the age group between 21 and 30 years. Congenital anomalies were seen more commonly (3.3%) in the multiparas in comparison with primiparas (1.8%). The predominant system involved was Musculo-skeletal system (33.2%) followed by gastro-intestinal (GI) system (15%). Talipes (17.1%) was the most common one in musculoskeletal group and likewise cleft lip and cleft palate in GI system. Congenital anomalies were more likely to be associated with low birth weight, prematurity, multiparity, consanguinity and cesarean delivery. Conclusion: Public awareness about preventable risk factors is to be created and early prenatal diagnosis and management of common anomalies is strongly recommended.
ABSTRACT
Background: Preterm labor and delivery are one of the challenging obstetric complications encountered by obstetricians, as are preterm neonates for the pediatricians. Therefore, this study was planned to identify etiological factors and to assess the neonatal mortality and morbidity associated with preterm labor and delivery. Methods: This prospective study was conducted over a 6 months period (September 2014 to February 2015) in the department of Obstetrics/Gynaecology and Paediatrics at Patliputra Medical College, Dhanbad, Jharkhand. 325 antenatal women admitted with threatened preterm labor, with or without rupture of membranes, were recruited. They were followed up from admission till delivery and discharge. Gestational age at onset of preterm labor, associated risk factors, response to tocolytics if given, gestational age at delivery, and neonatal outcome were recorded and analyzed.Results: Incidence of preterm labor was found to be 28.26% and that of preterm deliveries 25.9%. Preterm rupture of membranes and infection were the commonest causes of preterm labor. Irrespective of the use of a course of betamethasone, neonatal mortality was significantly higher (P<0.0001) in babies delivering before 34 weeks (30.4%) as compared to that in babies delivering after 34 weeks (3.4%). Septicemia, respiratory distress syndrome (RDS) and birth asphyxia were the important causes of neonatal morbidity.Conclusion: Our results revealed a high incidence of preterm labor and preterm births in comparison to developed countries. Infection is one important modifiable risk factor which can be reduced. Prolongation of delivery for 48 hours by giving tocolytics for getting the benefit of betamethasone coverage reduces morbidity due to RDS but does not reduce overall neonatal mortality below 34 weeks.