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Preterm labour and birth [NG25]

Measuring the use of this guidance

Recommendation: 1.2.1

Offer a choice of either prophylactic vaginal progesterone or prophylactic cervical cerclage to women: - with a history of spontaneous preterm birth or mid‑trimester loss between 16+0 and 34+0 weeks of pregnancy and - in whom a transvaginal ultrasound scan has been carried out between 16+0 and 24+0 weeks of pregnancy that reveals a cervical length of less than 25 mm. Discuss the benefits and risks of prophylactic progesterone and cervical cerclage with the woman and take her preferences into account.

What was measured: Proportion of preterm birth prevention clinics where short cervical length is classified as less than 25 mm.
Data collection end: July 2017
55%
Number that met the criteria: 18 / 33
Area covered: UK
Source: Care, A.; Ingleby, L.; Alfirevic, Z.; Sharp, A., The influence of the introduction of national guidelines on preterm birth prevention practice: UK experience, BJOG : an international journal of obstetrics and gynaecology, , 2018. https://doi.org/10.1111/1471-0528.15549

What was measured: Proportion of obstetric units without preterm birth prevention clinics where short cervical length is classified as less than 25 mm.
Data collection end: July 2017
63%
Number that met the criteria: 45 / 71
Area covered: UK
Source: Care, A.; Ingleby, L.; Alfirevic, Z.; Sharp, A., The influence of the introduction of national guidelines on preterm birth prevention practice: UK experience, BJOG : an international journal of obstetrics and gynaecology, , 2018. https://doi.org/10.1111/1471-0528.15549


Recommendation: 1.8.3

Offer nifedipine for tocolysis to women between 26+0 and 33+6 weeks of pregnancy who have intact membranes and are in suspected or diagnosed preterm labour.

What was measured: Proportion of obstetric units offering nifedipine as a first choice tocolytic.
Data collection end: July 2017
71%
Number that met the criteria: 75 / 106
Area covered: UK
Source: Care, A.; Ingleby, L.; Alfirevic, Z.; Sharp, A., The influence of the introduction of national guidelines on preterm birth prevention practice: UK experience, BJOG : an international journal of obstetrics and gynaecology, , 2018. https://doi.org/10.1111/1471-0528.15549


Recommendation: 1.9.3

Offer maternal corticosteroids to women between 26+0 and 33+6 weeks of pregnancy who are in suspected, diagnosed or established preterm labour, are having a planned preterm birth or have P‑PROM.

What was measured: Proportion of mothers who delivered their babies before 34 weeks who received any dose of antenatal steroids.
Data collection end: December 2016
86%
Number that met the criteria: 16317 / 18947
Area covered: England and Wales
Source: Royal College of Paediatrics and Child Health. National Neonatal Audit Programme.


Recommendation: 1.10.1

Offer intravenous magnesium sulfate for neuroprotection of the baby to women between 24+0 and 29+6 weeks of pregnancy who are: in established preterm labour or having a planned preterm birth within 24 hours.

What was measured: Proportion of mothers who delivered their babies before 30 weeks who received magnesium sulphate 24 hours prior to delivery.
Data collection end: December 2016
44%
Number that met the criteria: 1868 / 4242
Data collection end: December 2017
59%
Number that met the criteria: 2522 / 4276
Area covered: England and Wales
Source: Royal College of Paediatrics and Child Health. National Neonatal Audit Programme.

What was measured: Proportion of mothers who delivered their babies before 34 weeks who received any dose of antenatal steroids.
Data collection end: December 2017
87%
Number that met the criteria: 16550 / 18965
Area covered: England and Wales
Source: Royal College of Paediatrics and Child Health. National Neonatal Audit Programme.



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