Mortality rate of preterm neonates in two teaching hospitals in Teheran, Islamic Republic of Iran

In a retrospective study conducted in two teaching hospitals in Teheran, records of 573 preterm infants were reviewed. The birth weights ranged between 500 and 2500 grams, and the gestational ages between 24 and 36 weeks. This study indicated that the expected survival rate of neonates was greatly influenced by a gestational age of more than 32 weeks and a birth weight exceeding 1250 grams. The youngest surviving neonate was a female whose gestational age was 26-27 weeks and birth weight 1500 grams. The smallest surviving [in weight] was a female infant of 750 grams and a gestational age of 28-29 weeks. This study revealed that an increase in the age and weight of preterm neonates leads to a rapid decline in mortality rate

MAJOR DEGREE PLACENTA PRAEVIA;

Introduction: Placenta praevia is a major cause of maternal & fetal morbidity and mortality. It is a major cause of obstetrical haemorrhage in second and third trimester of pregnancy. Placenta pravia usually presents with antepartum haemorrhge and as a source of maternal morbidity, it remained a significant cause of hospitalization and caesarean section. The study was carried out to see the frequency of risk factors, maternal complications and perinatal outcome in major degree placenta praevia. Objectives: I). To Find out major risk factors and maternal complications in major degree placenta praevia. II). Know perinatal outcome in major degree placenta praevia. Study Design & Techniques: It is a descriptive study. Patients were selected by simple random sampling techniques. Settings: The study was carried out at Gynae Unit-I, Allied Hospital, Faisalabad from March 2005 to February, 2006. Subjects & Method: Seventy five patients selected for the study after fulfilling the inclusion criteria for major degree placenta praevia. The included patients were examined thoroughly and relevant information was recorded into proforma giving detailed history, clinical examination, investigation and management. Results: In this descriptive study, total 75 patients were included as a diagnosed a case of major degree placenta praeiva. There were 15 patients presented asymptomatically and the rest of 60 patients were symptomatic. Out of 75 patients, majority of the patients belonged to the age group of 24-35 years. The mean age was 31.5 years. 2 patients expired due to massive PPH, 10 patients underwent obstetrical hysterectomy. In these 10 patients, 3 patients had placenta accrete, 1 patient had placenta increta and 2 had placenta percreta. Predisposing factors were previous gynaecological operations in 15 patients, history of previous C-section in 14 patients, history of previous placenta praevia 8 patients, advanced maternal age 5 patients and history of myomectomy in 3 patients. The remaining 39 patients had no predisposing risk factor. The mean gestational age was 36 weeks. 57 babies were delivered by emergency C-section and the remaining 18 patients underwent elective C-section. Live birth account was 66. Out of 75 babies, 9 babies were IUD, 48 were preterm, 17 were IUGR, 25 babies were having RDS and 3 babies were abnormal congenitally and 13 perinatal deaths occurred. Conclusions: Significant improvement in the neonatal care should be achieved in our tertiary environment to improve expected survival rate together with a reduction in overall morbidity for the premature new born.