FOGSI FOCUS: Prevention of Preterm Labor Dr Jaideep Malhotra, Narendra Malhotra, Seema Pandey
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FOGSI FOCUS Prevention of Preterm Labor
Editors Narendra Malhotra MD FICMCH FICOG FICS FMAS FRCOG AFIAPM Vice President, World Association Perinatal Medicine President, ISPAT Agra, Uttar Pradesh, India Jaideep Malhotra MD FICMCH FICOG FICS FMAS FRCOG FRCPI President Elect, FOGSI-2018, President Elect, ISPAT Vice President, ISAR, Past President, ASPIRE Regional Director, Ian Donald School of Ultrasound Agra, Uttar Pradesh, India Co-editor Seema Pandey MD FICOG FRM Director, Seema Hospital and Eva Fertility Clinic and IVF Centre Azamgarh, Uttar Pradesh, India President Rishma Dhillon Pai MD DNB FCPS DGO FICOG President 2017, Federation of Obstetricians and Gynaecologists of India (FOGSI) President Elect, ISAR-2018, Vice President, IAGE Hon. Gen. Secretary, Mumbai Obstetrics and Gynecological Society Board Member, World Endometriosis Society
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FOGSI FOCUS Prevention of Preterm Labor / Narendra Malhotra, Jaideep Malhotra
First Edition: 2018
9789352702299
Printed at
fm4Contributors
EDITORS
CO-EDITOR
CONTRIBUTING AUTHORS
fm6Message
Rishma Dhillon Pai MD DNB FCPS DGO FICOG
President 2017, Federation of Obstetricians and Gynaecologists of India (FOGSI)
President Elect, ISAR-2018
Vice President, IAGE
Hon. Gen. Secretary, Mumbai Obstetrics and Gynecological Society
Board Member, World Endometriosis Society
“Challenges are what make life interesting, overcoming them is what make life meaningful”
-Joshna J Marine
Life is full of challenges and difficult situations. In the practice of obstetrics, one such situation is preterm birth. There are many diverse etiologies and many reasons why preterm labor or premature rupture of membranes occurs. Often there is no clear effective prevention or treatment options. The birth of a preterm baby is frought with risks and complications for the baby.
This is a situation which can be very stressful and frustrating for the obstetrician and the parents.
We decided this year to bring out a FOGSI FOCUS on Prevention of Preterm Labor. Dr Narendra and Dr Jaideep Malhotra along with Dr Seema Pandey, all experts in the field have done an excellent job of detailing all the updated knowledge on the subject.
A special thanks to Sun Spectra, for their support.
I am sure that this will be an extremely useful FOGSI FOCUS for all of you and you will enjoy reading it.
Rishma Dhillon Paifm7
fm8Preface
Editors
Narendra Malhotra MD FICMCH FICOG FICS FMAS FRCOG AFIAPM
Vice President, World Association Perinatal Medicine President, ISPAT
Agra, Uttar Pradesh, India
Jaideep Malhotra MD FICMCH FICOG FICS FMAS FRCOG FRCPI
President Elect, FOGSI-2018
President Elect, ISPAT
Vice President, ISAR
Past President, ASPIRE
Regional Director, Ian Donald School of Ultrasound
Agra, Uttar Pradesh, India
Co-editor
Seema Pandey MD FICOG FRM
Director, Seema Hospital and Eva Fertility Clinic and IVF Centre
Azamgarh, Uttar Pradesh, India
Out of all the anthropoid species, the human neonate is born much more immature, perhaps it is the nature's mechanism to avoid the large head of the human fetus from becoming impacted in small pelvis of the mother who has adapted to a bipedal gate.
Preterm labor is one of the 5 “P” problems of pregnancy. In last few decades, the practice of obstetrics has seen many advances in diagnostic tools along with availability of various modalities to improve the outcome. However, one thing which still baffles the whole community is a static or increased risk of preterm labor and premature deliveries even in developed countries, which in turn increases the socioeconomic burden as these newborns need special care and there are so many long-term consequences to bear with.fm9
According to Norwegian study, disability is found in around 60% of survivors born at 26 weeks and 30% of those who are born at 31 weeks. Few of the disabilities to enumerate are chronic lung disease, visual and hearing loss, and neurodevelopmental handicaps. Males always have a higher absolute mortality rate than their female counterparts. In the third world and developing countries, like India, this burden is far too much to tackle. These newborns even if they survive the first year of life, they are at increased risk of various morbidities and compromised intelligence throughout the life.
Phillips and colleagues in a very interesting study found that low birth weight in men was associated with lower social class, income, and rate of marriage. About 20% of men weighing less than 2,500 g at birth had never married compared with about 10% of men with normal birth weight. Both male and female survivors of preterm birth had low educational achievement than survivors of term birth. However, they could not make it out whether this is a result of being born preterm or of being born into a high risk social setting with poor parental education and a high rate of unmarried parents. However, in their opinion, this poor educational attainment is likely to function as an outcome or consequence of preterm birth. While biological factors may be at the root of the problem, inter-related social and economic stressors likely also diminish reproductive ability.
A dedicated edition of preterm labor was needed to sensitize the psyche and upgrade the knowledge of practicing gynecologists in our country. We need to bring up our own studies to find the exact burden of this problem in our country and the leading causes. Our research should focus on the combination of noninvasive markers targeted at high risk population for screening, these studies should be powered enough to detect not only the cutoffs for positive tests but predictive values too.
This multiauthored FOGSI focus is a comprehensive collection of all aspects of preterm labor. The authors have done a great job in rehearsing each topic and compiling relevant information which will be useful to the practising obstetrician.
We hope all FOGSIANS will benefit from this manuscript.
Happy Reading!
fm10Acknowledgments
We are thankful to Dr Rishma Dhillon Pai and FOGSI-2017 team for entrusting the responsibility of this FOGSI FOCUS on Preterm Labor to us.
The authors selected one the yuva brigade of FOGSI and all have been very prompt in submitting the manuscript in well time.
Thank you Sun Pharma for bringing out an important issue! Thank you all!