The assessment of preterm labor cases in terms of maternal fetal aspects

Abstract

Objective: The aim is to identify the reasons of preterm labor, which is the most important reason for perinatal mortality and morbidity, and of morbidity and mortality seen in mothers and babies due to preterm labor, to help the development of strategies to eliminate these reasons, and to provide guidance for the planning of efficient treatment model, if any. Methods: Of 1095 patients who admitted to the Department of Obstetrics and Gynecology, Faculty of Medicine, Eskiflehir Osmangazi University and had labor between January 2008 and January 2010, 213 (19%) had preterm labor between 20 weeks and 36 weeks and 6 days of gestation. Of these 213 patients, 185 whose records could be accessed and the newborns of these labors were included in the study. The data were obtained from the patient files retrospectively. Results: In our study, 19% of all labors were preterm labor. Of preterm labors, the reason for 51.9% was spontaneous onset of preterm labor, 7% was premature rupture of membrane, and 38.9% was maternal-fetal problems. When the weeks of gestation and the complications of newborn period were evaluated, it was seen that the mortality rate and the complications such as intracranial hemorrhage, convulsion, respiratory distress syndrome, intubation, surfactant need and newborn retinopathy increased as the gestational age decreased. Conclusion: Preterm labor is one of the most significant perinatal mortality and morbidity reasons. The low socioeconomic level and insufficient antenatal care capabilities increase these risks further. In our study, we reached the conclusions supporting the results that the mortality rates and prematurity-associated complications in premature newborns correlate with the birth weight and gestational age during labor, and the decrease in them leads to a decline in the survival rate.

Özet

Amaç: En önemli perinatal mortalite ve morbidite nedeni olan erken do¤umun ve buna ba¤l› olarak anne ve bebekte görülen morbidite ve mortalitenin nedenlerini saptamak, bu nedenlerin ortadan kald›r›lmas›na yönelik stratejilerin gelifltirilmesine yard›mc› olmak ve e¤er varsa etkin tedavi modelinin planlanmas›nda rehberlik görevi oluflturmakt›r. Yöntem: Ocak 2008 ile Ocak 2010 y›llar› aras›nda Eskiflehir Osmangazi Üniversitesi T›p Fakültesi Kad›n Hastal›klar› ve Do¤um Bölümüne baflvuran ve do¤um yapan toplam 1095 hastadan 213’ü (%19) 20 hafta ile 36 hafta 6 gün aras›nda preterm do¤um yapm›flt›. ‹ki yüz on üç hastadan, hastane kay›tlar›na ulafl›labilen 185 hasta ve bu gebelikler sonucu do¤mufl olan yenido¤anlar çal›flmaya dahil edildi. Veriler hasta dosyalar›ndan retrospektif olarak sa¤land›. Bulgular: Çal›flmam›zda, tüm do¤umlar›n %19’u preterm do¤um idi. Preterm do¤umlar›n %51.9’u preterm eylem, %7’si erken membran rüptürü, %38.9’u ise maternal-fetal problemler nedeniyle gerçekleflmiflti. Do¤um haftas› ile yenido¤an dönemine ait komplikasyonlar de¤erlendirildi¤inde, gestasyonel yafl azald›kça intrakraniyal kanama, konvülziyon, respiratuvar distres sendromu, entübe edilme, surfaktan ihtiyac›, yenido¤an retinopatisi gibi komplikasyonlar›n ve mortalitenin artt›¤› görüldü. Sonuç: Preterm do¤um en önemli perinatal mortalite ve morbidite nedenlerindendir. Sosyoekonomik düzeyin ve antenatal bak›m imkanlar›n›n düflüklü¤ü bu riskleri daha da art›rmaktad›r. Çal›flmam› zda, prematür bebeklerde mortalite h›zlar›n›n ve prematüriteye ba¤l› komplikasyonlar›n do¤um a¤›rl›¤› ile do¤umdaki gestasyonel yafla ba¤l› oldu¤unu ve her ikisindeki düflüflün de sürvide azalmaya neden oldu¤unu destekleyen sonuçlara ulaflt›k.