PRETERM DELIVERY: A MAJOR PREDICTOR OF PERINATAL MORBIDITY AND MORTALITY

Objective: To observe the risk factors for preterm labour and perinatal outcome in preterm fetuses.Material and Methods: This descriptive observational study was carried out in department of Obstetrics and Gynaecology, Hayatabad Medical Complex, Peshawar from 1s December 2001 to 2002. Preterm deliveries confirmed by dates or early ultrasound between 28 and 36.6 weeks of gestation were included in this study. Socio demographic and clinical data was collected on a proforma. All data was analyzed using various statistical tests.Results: During this study period, 100 cases were observed. Significant obstetrical risk factors for preterm labour were preterm rupture of membranes and malpresentation. 104 babies were born; where 10 babies were expired, thus perinatal mortality was 9.6%. The main causes of perinatal death were birth asphyxia (40%), respiratory distress (20%), and neonatal jaundice (20%o). Breech presentation, period of gestation (<32 weeks) and birth weight < 2 kg were the significant risk factors for perinatal mortality.Perinatal morbidity occurred in 20 (19.2 %) babies. Significant morbidity was birth asphyxia (n=6), neonatal jaundice (n=6) and respiratory distress (n=4).Conclusion: Significant risk factors for preterm labour were preterm premature rupture of membranes and malpresentation. Breech presentation, period of gestation and birth weight (< 2 kg) significantly contributed to early neonatal morbidity and mortality. These reflect ignorance and poor health services, which need to be improved by improving prenatal health services and advanced neonatal care.