Preterm labor-still a challenge

ABSTRACT

To identify the frequency of different aetiological factors of preterm labour, and to suggest preventive measures to reduce its incidence. Prospective, descriptice study from June 2005 to Dec. 2005. Setting: Department of Gynaecology and Obstetrics [Unit III], Civil Hospital, Karachi. One hundred pregnant women having one foetus, with preterm labour [<37 weeks]. Information regarding past history, present symptoms, menstrual and obstetrical history, findings of clinical examination and investigations like haemoglobin%, total leucocyte count, platelet count, random blood sugar, urine D/R [microscopy, culture, and sensitivity], high vaginal swab [gram staining, culture and sensitivity] and ultrasound pelvis [for gestational age, amount of liquor, placental localization, placental abruption, fetal and uterine abnormalities] were recorded on a proforma and the results analyzed. Out of the 100 women with preterm labour, 50% were<25 years of age, 80% belonged to the lower socio-economic group, 70% were not booked cases, 40% were primigravida and 18% had a past history of preterm labour. Urinary tract infection was found in 32% of the cases, bacterial vaginosis in 13%, abruptio placenta in 18%, unexplai-ed antepartum haemorrhage [APH] in 2%, polyhydramnios in 5%, pregnancy induced hypertension in 4%, cervical incompetence in 2%, fetal anomalies in 2% and pulmonary Kock?s in 1% cases; in 21% cases no risk factors could be identified. Preterm labour and delivery are a major cause of perinatal morbidity and mortality, specially in the developing countries. The costs of neonatal intensive care in short term and the resources needed to support children with long-term morbidity as a result of preterm birth are considerable. Preventable and treatable causes of preterm labour should be identified and dealt with for the better maternal and foetal outcome: