Skip to main content
SpringerLink
Log in

Practices for predicting and preventing preterm birth in Ireland: a national survey

  • Original Article
  • Published:
Irish Journal of Medical Science Aims and scope Submit manuscript

Abstract

Background

Preterm birth can result in adverse outcomes for the neonate and/or his/her family. The accurate prediction and prevention of preterm birth is paramount. This study describes and critically analyses practices for predicting and preventing preterm birth in Ireland.

Methods

A questionnaire seeking information on practices for predicting and preventing preterm birth was mailed to all consultant obstetricians practising in Ireland in February 2006.

Results

For predicting preterm birth, 97% of respondents did not use foetal fibronectin testing, 71% carried out routine second and third trimester cervical assessments and 75% routinely screened for genital tract infection. For preventing preterm birth, 62% prescribed bed rest, 24% prescribed antibiotics, 14% routinely inserted a cervical cerclage in women with a history of mid-trimester miscarriage and 61% routinely used tocolytics.

Conclusion

The findings of this survey, for the most part, reflect the empirical evidence base, international practices and best practice recommendations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. World Health Organisation (2003) Managing Newborn Problems. A Guide for Doctors, Nurses and Midwives. Geneva: World Health Organisation

  2. Goldenberg RL (2002) The management of preterm labor. Obstet Gynecol 100(5 Pt 1):1020–1037

    Article  PubMed  Google Scholar 

  3. Tucker J, McGuire W (2004) ABC of preterm birth; epidemiology of preterm birth. Br Med J 329:675–678

    Article  Google Scholar 

  4. Klein LL, Gibbs RS (2004) Use of microbial cultures and antibiotics in the prevention of infection-associated preterm birth. Am J Obstet Gynecol 190(6):1493–1502

    Article  CAS  PubMed  Google Scholar 

  5. Hollier LM (2005) Preventing preterm birth; what works, what doesn’t. Ultrasound Obstet Gynecol 60:124–131

    Google Scholar 

  6. Lindsey P (2004) Preterm Labour. In: Henderson C, MacDonald S, editors. Mayes’ Midwifery: A Textbook for Midwives. Balliere Tindall, London

    Google Scholar 

  7. Green NS, Damus K, Simpson JL et al (2005) Research agenda for preterm birth: recommendations from the March of Dimes. AJOG 193:626–635

    Article  Google Scholar 

  8. Ingemarsson I, Lamont RF (2003) An update on the controversies of tocolytic therapy for the prevention of preterm birth. Acta Obstet Gynecol Scand 82(1):1–9

    PubMed  Google Scholar 

  9. Cook CM, Peek MJ (2004) Survey of the management of preterm labour in Australia and New Zealand. Aus NZ J Obstet Gynecol 44:35–38

    Article  Google Scholar 

  10. Ramsey PS, Nuthalapathy FS, Lu G et al (2004) Contemporary management of preterm premature rupture of membranes (PPROM): a survey of maternal—fetal medicine providers. AJOG 175:1146–1151

    Google Scholar 

  11. Higgins S (2004) Cervical suture survey

  12. Chien PF, Khan K, Ogston S, Owen P (1997) The diagnostic accuracy of cervico-vaginal fetal fibronectin in predicting preterm delivery: an overview. BJOG 104(4):436–444

    Article  CAS  Google Scholar 

  13. Faron G, Boulvain M, Irion O, Bernard PM, Fraser WD (1998) Prediciton of preterm delivery by fetal fibronectin: a meta-analysis. Obstet Gynecol 92:153–158

    Article  CAS  PubMed  Google Scholar 

  14. Honest H, Bachmann LM, Gupta JK, Kleijnen J, Khan K (2002) Accuracy of cervicovaginal fetal fibronectin test in predicting risk of spontaneous preterm birth: a systematic review. Br Med J 325(7359):301

    Article  Google Scholar 

  15. Revah A, Hannah ME, Sue-A-Quan AK (1998) Fetal fibronectin as a predictor of preterm birth: An overview. Am J Perinatol 15:153–158

    Article  Google Scholar 

  16. Smith V, Devane D, Begley C, Clarke M, Higgins S (2007) A systematic review and quality assessment of systematic reviews of fetal fibronectin and transvaginal sonographic cervical length for predicting preterm birth. Eur J Obstet Gynecol Reprod Biol 133:134–142

    Article  CAS  PubMed  Google Scholar 

  17. Revah A, Hannah ME, Sue-A-Quan AK (1998) Fetal fibronectin as a predictor of preterm birth: an overview. Am J Perinatol 15:153–158

    Article  Google Scholar 

  18. Chien PF, Khan KS, Ogston S, Owen P (1997) The diagnostic accuracy of cervico-vaginal fetal fibronectin in predicting preterm delivery: an overview. Br J Obstet Gynaecol 104(4):436–444

    Article  CAS  PubMed  Google Scholar 

  19. Faron G, Boulvain M, Irion O, Bernard PM, Fraser WD (1998) Prediction of preterm delivery by fetal fibronectin: a meta-analysis. Obstet Gynecol 92:153–158

    Article  CAS  PubMed  Google Scholar 

  20. Honest H, Bachmann LM, Gupta JK, Kleijnen J, Khan KS (2002) Accuracy of cervicovaginal fetal fibronectin test in predicting risk of spontaneous preterm birth: systematic review. Br Med J 325(7359):301

    Article  Google Scholar 

  21. Honest H, Bachmann LM, Coomarasamy A, Gupta JK, Kleijnen J, Khan KS (2003) Accuracy of cervical transvaginal sonography in predicting preterm birth: a systematic review. Ultrasound Obstet Gynecol 22(3):305–322

    Article  CAS  PubMed  Google Scholar 

  22. Leitich H, Brunbauer M, Kaider A, Egarter C, Husslein P (1999) Cervical dilatation of the internal cervical os detected by vaginal ultrasonography as markers for preterm delivery: a systematic review. Am J Obstet Gynecol 181:1465–1472

    Article  CAS  PubMed  Google Scholar 

  23. Gibbs RS, Romero R, Hillier SL, Eschenbach DA, Sweet RL (1992) A review of premature birth and subclinical infection. Am J Obstet Gynecol 166(5):1515–1528

    CAS  PubMed  Google Scholar 

  24. Greer IA (1991) Thrombosis in pregnancy: maternal and fetal issues. Lancet 353:1258

    Article  Google Scholar 

  25. Maloni JA, Bresinski-Tomasi JE, Johnson LA (2001) Antepartum bed rest: effect on the family. J Obstet Gynecol Neonat Nurs 23:421–427

    Google Scholar 

  26. King J, Flenady V (2002) Prophylactic antibiotics for inhibiting preterm labour with intact membranes. Cochrane Database Syst Rev (4):CD000246

  27. Kenyon SL, Taylor DJ, Tarnow-Mordi W (2001) Broad-spectrum antibiotics for spontaneous preterm labour: the ORACLE II randomised trial. ORACLE Collaborative Group. Lancet 357(9261):989–994

    Article  CAS  PubMed  Google Scholar 

  28. Royal College of Obstetricians & Gynaecologists. Guideline no. 44: preterm prelabour rupture of membranes. London: RCOG, 2006

  29. Shennan A, Crawshaw S, Briley A et al (2006) A randomsied controlled trial of metronidazole for the prevention of preterm birth in women positive for fetal fibronectin: the PREMET study. BJOG 113:65–74

    CAS  PubMed  Google Scholar 

  30. Shennan A, Crawshaw S, Briley A et al (2006) A randomised controlled trial of metronidazole for the prevention of preterm birth in women positive for fetal fibronectin: the PREMET study. BJOG 113:65–74

    CAS  PubMed  Google Scholar 

  31. Kenyon SL, Taylor DJ, Tarnow-Mordi W (2001) Broad-spectrum antibiotics for preterm, prelabour rupture of fetal membranes: the ORACLE I randomised trial. ORACLE Collaborative Group. Lancet 357(9261):979–988

    Article  CAS  PubMed  Google Scholar 

  32. MRC/RCOG. Final report of the Medical Research Council/Royal College of Obstetricians and Gynaecologists multicentre randomised trial of cervical cerclage. BJOG, 1993 100:516–523

    Google Scholar 

  33. Althuisius SM, Dekker GA, Hummel P, Bekedam DJ, van Geijn HP (2001) Final results of the cervical incompetence prevention randomized cerclage trial (CIPRACT): therapeutic cerclage with bed rest versus bed rest alone. Am J Obstet Gynecol 185(5):1106–1112

    Article  CAS  PubMed  Google Scholar 

  34. To MS, Alfirevic Z, Heath VCF, Cacho AM, Williamson PR, Nicolaides KH (2004) Cervical cerclage for prevention of preterm delivery in women with short cervix: randomized controlled trial. Lancet 363:1849–1853

    Article  PubMed  Google Scholar 

  35. RCOG (2002) Clinical guideline NO.1 (B): tocolytic drugs for women in preterm labour. London: RCOG

  36. Ables AZ, Romero AM, Chauhan SP (2005) Use of calcium channel antagonists for preterm labor. Obstet Gynecol Clin N Am 32(3):519–525

    Article  Google Scholar 

  37. AB F (2000) Tractocile: sumary of product characteristics. Ferring AB, Sweden

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Nursing and Midwifery, Trinity College Dublin, The University of Dublin, 24 D’Olier Street, Dublin 2, Ireland

    V. Smith

  2. School of Nursing and Midwifery, Aras Moyola, National University of Ireland, Galway, Galway, Ireland

    D. Devane

  3. National Maternity Hospital, Dublin, Ireland

    S. Higgins

Authors
  1. V. Smith
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. D. Devane
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S. Higgins
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to V. Smith.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Smith, V., Devane, D. & Higgins, S. Practices for predicting and preventing preterm birth in Ireland: a national survey. Ir J Med Sci 180, 63–67 (2011). https://doi.org/10.1007/s11845-010-0604-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11845-010-0604-1

Keywords

Search

Navigation