Analysis of Preterm Birth Screening Clinic Outcomes in Luton and Dunstable hospital

Introduction

This audit evaluates the performance of the specialized preterm birth screening clinic at Luton and Dunstable Hospital in 2024, assessing referral appropriateness, timing of evaluation, and the correlation between cervical length and gestational outcomes. The study aligns with the objectives of Saving Babies’ Lives Care Bundle Version 3 (SBLCBv3), which emphasizes early detection and management of preterm birth risks to improve perinatal outcomes.

Methods

A retrospective cohort analysis was conducted on women referred to the clinic between January and December 2024. Data on risk factors, cervical length measurements, management, and outcomes were collected from clinical proformas and case notes.

Results

A total of 230 women attended the clinic, with 88.26% (n=203) meeting eligibility criteria. The majority of eligible referrals were for previous preterm birth (31.18%) and second-trimester loss (26.34%), reflecting high-risk profiles. Most women (56%) were evaluated between 16-18 weeks’ gestation, while the earliest evaluations occurred at earlier gestations for a smaller subset of patients.

Cervical length at the first appointment correlated with gestational outcomes were 57% of women with cervical length <25mm delivered after 36 weeks, 41% of women with cervical length 25-35mm delivered after 36 weeks and 53% of women with cervical length >35mm delivered after 36 weeks.

These findings emphasize the critical role of early cervical length assessment in guiding intervention and improving outcomes.

Recommendations

From the audit, the following recommendations are proposed. Improve Referral Accuracy: Enhance training for referrers to ensure 100% of referrals meet eligibility criteria, minimizing inappropriate referrals and optimizing clinic resources. Encourage Earlier Evaluations: Strengthen processes to prioritize early gestational evaluations for high-risk patients, maximizing intervention windows. Targeted Interventions: Develop standardized pathways for managing women with cervical lengths <25mm, incorporating early interventions like progesterone therapy or cervical cerclage as per SBLCBv3. Ongoing Data Analysis: Continue auditing outcomes to refine clinical protocols and monitor the impact of interventions, ensuring evidence-based care.

Conclusion

This audit demonstrates that the preterm birth screening clinic effectively identifies and manages high-risk patients, with 88.26% eligible referrals and a significant proportion receiving timely evaluation. The correlation between cervical length and gestational outcomes underscores the importance of targeted, early interventions. By implementing the recommended improvements, the clinic can further enhance compliance with SBLCBv3, improve resource efficiency, and optimize outcomes for mothers and babies. Regular audits will sustain progress in reducing preterm births and associated risks.