Asifa Ghazi, Shazia Jabbar, Nasima M Siddiq.
Preterm labor - still a challenge!.
Pak J Surg Jan ;22(4):222-6.

Objective: To identify the frequency of different aetiological factors of preterm labour, and to suggest preventive measures to reduce its incidence. Design & Duration: Prospective, descriptice study from June 2005 to Dec. 2005. Setting: Department of Gynaecology & Obstetrics (Unit III), Civil Hospital, Karachi. Patients: One hundred pregnant women having one foetus, with preterm labour (<37 weeks). Methodology: 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. Results: 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. Conclusion: 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.

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