Ranoji Vijaysing Shinde

Abstract

Background: To determine the incidence of preterm labour and also to determine the incidence and various cause of Morbidity and Mortality in the perinatal period. Materials and Methods: A prospective study of patients in preterm labour (delivered > 28 weeks and prior to 37 completed weeks) admitted to the obstetrics department of JSS Hospital Mysore Karnataka. Which is tertiary teaching hospital. The study was conducted between February 2012 to January 2014. Total number of deliveries during the period were 3209 out of which the number of preterm deliveries were 241 which fulfilled our study criteria. Immediately. Following delivery, the following features of baby noted like Sex, weight, APGAR score at 1 and 5-minute, immediate complications, congenital Anomaly, birth injury, gestational age, as assessed by the paediatrician based on modified Ballard scoring. Babies and mother followed up for a period of 7 days. Baby examined for the detection of any complication which were managed accordingly. During the study the various risk facters associated with preterm labour were also determined in detail and the correlation of the risk factors to antenatal care, maternal age, parity, presentation and lie, mode of delivery, indication of caesarean sections was studied in detail. So, this study we studied the behavioural pattern of the mother and baby towards preterm labour in detail. The data collected as mentioned above were analysed using appropriate statistical methods. Results: The total number of preterm deliveries were 241 out of the total number of 3269 deliveries in the period of 2 years of the study. Therefore, the incidence of preterm labour was 7.4%. Out of which the total number of preterm spontaneous labour cases were180 (74.7%) and total number of elective preterm delivery were 61 (25.3%). The total number of mortalities during the perinatal period was 82 which accounts of perinatal mortality of 30%. Out of which the total number of stillbirths were 28 (34%) and total number of early neonatal deaths were 54 (66%). Conclusions: To conclude it was seen that preterm labour was associated with high occurrence of perinatal morbidity and mortality. The main causes were found due to birth asphyxia, respiratory distress syndrome and septicaemia. Preterm labour was more common in primigravida with preterm premature rupture of membrane as triggering factors. Preterm babies were born with number of physiological handicaps and thus predisposed to a large number of pathological conditions which needs anticipation and prompt treatment. Thus, timely identification of the risk factors and prompt treatment would help to bring down the incidence of preterm labour and hence its perinatal mishap. And lastly improvement of health care services and good neonatal intensive care unit are the cornerstone in the management of preterm births. Keywords: Perinatal morbidity and mortality, Preterm delivery.

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Abstract

Background: Several histopathological features are found more frequently in placentas from pregnancies complicated by foetal growth restriction (FGR), including villous infarction, maternal vascular changes and villous morphological alterations, although around one quarter of placentas associated with FGR lack any morphological abnormality on routine examination. So, our aim is to study various morphometric and morphological changes in placentae of small for gestational age babies. The correlation of various maternal parameters like height, age and parity with the foetal weight, placental weight, foeto-placental ratio (F/P) and placental coefficient (PC) and lastly to know whether each diseases process has any specific change in placentae. Material and Methods: A prospective randomised control study was conducted from August 2016 to August 2018 in the Department of obstetrics and gynaecology JSS Hospital Mysore Karnataka. The total number of deliveries during this period were 3430. Out of which 397 babies were diagnosed of having Intrauterine growth retardation (IUGR) Total number of 150 cases were studied out of which 100 placenta were from IUGR group (study group) and the remaining 50 placenta from healthy full term pregnancies(Control group). Results: The incidence of IUGR in our study was 11.6%. The commonest maternal cause for IUGR was anaemia 43%, followed by 18 % cases of preeclampsia and in 37% cases cause was Idiopathic. Maternal characters such as age, parity, and height were studied in relation to foetal outcome. An increase in the birth weight and placental weight was found with an increase in maternal age, height as well as parity. The mean placental weight in IUGR group was 484 grams while in control group was 520 grams. The average surface area in placentae in study group was 200.96 sq.cms. While in control group was 254 sqcms. Keywords: Intrauterine growth retardation (IUGR), Placenta, Trophoblast, Villous.

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