Maternal and perinatal outcome of clinical chorioamnionities patients admitted to labour ward of St. Paul's millennium medical college: A prospective cohort study
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Background: Overall, 1–4% of all births in the US are complicated by chorioamnionitis. However, the frequency of chorioamnionitis varies markedly by diagnostic criteria (clinical Vs histologic), specific risk factors and gestational age. Clinical chorioamnionities is associated with a number of adverse maternal and neonatal outcomes. So far there are no studies that assed prevalence or impact of chorioamnionities in our country.
Objective: The main objective of this study is to determine the maternal and neonatal outcome of women with clinical chorioamnionities at St.Paul Hospital Millenium Medical College.
Methods: Prospective cohort study design was used to determine the the maternal and neonatal outcome of women with clinical chorioamnionities at St.Paul Hospital Millenium Medical College. By using power of 80% and CI of 95%, ratio of sample size unexposed to exposed 2:1 open Epi software auto calculates total smple size of 168, 56 cases and, 112 controls. The controls were those mothers who gave birth immediately after the case matched with gestational age.Selected adverse outcome were compared between pregnancies with and without clinical chorioamnionitis using relative risk and 95% CI.Statistical analysis was carried out using SPSS 21 version. Relative risk, 95% confidence intervals (CI) and two-tailed P values were calculated.
Result: The duration of labour and ROM has statistically significant association with occurrence of chorioamnionities with a p value and relative risk of of 0.020, RR1.538 (1.082 -2.187) and 0.000 RR3.304 (2.201 – 4.961) respectively. Caesarean section rates for dystocia were nearly triple in cases (29.1%, whereas it was 9.8% for controls. Women with chorioamnionities were more likely to have surgical site infection and postpartum endometrities. Likewise, the neonates of women with chorioamnionitis were at increased risk of admission to NICU and to have confirmed sepsis.
Conclusion: Maternal complications dystocia and need for oxytocin labor stimulation and also postpartum wound complication and endometrities are all increased in women with chorioamnionities. Neonates also suffered morbidities related to sepsis and require multiple interventions like antibiotics, anticonvulsants, oxygen support and phototherapy.