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- Title
The experience and outcomes of a specialised preterm birth clinic in New Zealand.
- Authors
Dawes, Lisa; Restall, Antonia; de Sousa, Joana; Pole, James Richard; Waugh, Jason; Groom, Katie
- Abstract
Background: A greater understanding of the risk factors for spontaneous preterm birth and the importance of risk stratification to guide interventions has led to the introduction of preterm birth prevention clinics. Aim: To evaluate the experience and outcomes of the first specialised preterm birth clinic in New Zealand. Materials and methods: This observational study reviewed pregnancies cared for in a preterm birth clinic from 2013 to 2018. Cases were identified and data collected from a maternity database and electronic medical records. Analysis was by referral type. Results: A total of 423 cases were included; 309 elective and 22 acute referrals in pregnancy, and 92 consultations outside pregnancy. For those referred electively in pregnancy, 138/309 (44.7%) fulfilled multiple referral criteria, and 57/309 (18.4%) had ≥2 previous spontaneous preterm births or second trimester losses. Excluding five pregnancies with first trimester miscarriage, 77/304 (25.3%) were managed with a history‐indicated cerclage (11 placed pre‐conception) and 217/304 (71.4%) had cervical surveillance as primary management, of which 133 (61.3%) did not require treatment. The remaining had treatment for a short cervix; 37 (17.0%) received an ultrasound‐indicated cerclage only, 21 (9.7%) vaginal progesterone only and 26 (12.0%) both. Five women (1.6%) had a second trimester loss at 13+0–19+6 and 58/297 (19.5%) had a spontaneous preterm birth at 20+0–36+6 weeks. The 'take home baby' rate was 95.4%. Conclusions: Pregnancy outcomes were similar to those reported by other preterm birth prevention clinics. The majority of women who received cervical surveillance as primary management were able to avoid additional treatment.
- Subjects
NEW Zealand; CERVIX uteri surgery; CLINICS; DATABASES; PREMATURE infants; MEDICAL referrals; MISCARRIAGE; SCIENTIFIC observation; HEALTH outcome assessment; PREGNANCY complications; PROGESTERONE; ELECTIVE surgery; DATA analysis software; ELECTRONIC health records; CERVICAL cerclage
- Publication
Australian & New Zealand Journal of Obstetrics & Gynaecology, 2020, Vol 60, Issue 6, p904
- ISSN
0004-8666
- Publication type
Article
- DOI
10.1111/ajo.13176