Title : Outcome of pregnancies managed by preterm clinic
Abstract:
Background: 53,000 babies are born prematurely each year in the UK. In 2021 7.6% of births are preterm, which was an increase from 7.4% in 2020. Preterm birth is a major cause of perinatal mortality. North West has introduced a preterm guideline regarding preterm Clinic. Since 10/2021 there is a standard operating procedure outlining the operational management of pre-term clinic for women who have been identified as being at increased risk of preterm labour/birth during their booking appointment. These women are seen at a specialist consultant clinic from 16/40 to 24/40 .The SOPs is planned to be reviewed very 3 years .Saving babies lives’ government incentive of reducing preterm birth from 8% to 6% by 2025.
Method: A retrospective audit looking at all patients referred to the Preterm Clinic during the time period between 1/03/2022 and 31/05/2022.
Results: 2 patients who were not seen in PTL clinic, had history indicated cerclage and cyclogest, one delivered at <28 weeks, the other 34-37 weeks. Out of 4 patients born <28 weeks, all had cyclogest and 3 had cerclage. They delivered preterm despite full treatment. 66% of high risk patients had full term delivery. 34% had preterm delivery, of which 24% was spontaneous preterm birth and 10% iatrogenic. Spontaneous Preterm delivery was prevented in 3 quarters of the high risk patients. 98% were given verbal and written advice regarding signs and symptoms of preterm labour and were advised to contact triage if symptoms of preterm labour.
Conclusion: The establishment of a dedicated preterm birth prevention clinic has significantly improved care in a condensed timeframe. Patient feedback and outcome was instrumental in refining clinic operations, leading to an improved information leaflet. Aim is to Continue following SOPs and Guidelines .Highlighting appropriate referral indications and disseminating this information amongst colleagues is imperative to avoid unnecessary referrals. This clinic commits to a multidisciplinary approach in refining preterm birth prediction and prevention aligning with Saving Babies Lives care Bundle objectives to reduce perinatal mortality.
