How effective are preterm birth clinics in reducing premature birth?

Background 

Aims

Methods

• Review

Single-centre, retrospective review of all women seen in Preterm birth clinic from September 2017 to August 2018

• Data collection and analysis

Independently collected by 2 reviewers; analysed with Excel & SPSS

Indication for referral, demographic & clinical variables, perinatal outcomes

Results (figures)

Total cohort: 89 women (87 singleton, 2 multiple pregnancies)

Results presented by risk assessment (Fig 1-2), surveillance (Fig 3-4), interventions (Fig 5-7) and outcomes (Fig 8-9) as follows:

Figure 1: main indication for referrals included previous PTB followed by LLETZ without PTB, late miscarriage and LLETZ with PTB

Figure 2: 1/3 of referrals were from ethnic minorities (in keeping with the local population -approx 1/4 non-UK born women in Sheffield-)

Figure 3 and 4: monitoring was mostly done with CL +/- fFN (regression model statistically significant combining both markers in asymptomatic women between 26-28 weeks gestation)

Figure 5-7: most women were managed conservatively. Those who received progesterone or cerclage saw an increase in gestational age and birthweight compared to their previous births

Figure 8-9: most pregnancies reached >37 weeks. Only 1/3 of women with previous PTB recurred but with significantly higher birthweight and longer gestations which translated into fewer neonatal complications and shorter stay in SCBU

Conclusions and future work