Conference Proceedings - School of Nursing & Midwifery - Trinity ...

School of Nursing & Midwifery, Trinity College Dublin: 8 th Annual Interdisciplinary Research Conference
Transforming Healthcare Through Research, Education & Technology: 7 th – 9 th November 2007
Conference Proceedings
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Practices for Predicting and Preventing Preterm Birth;
A National Survey.
Valerie Smith, Midwifery Research Assistant 1
Declan Devane, Lecturer in Midwifery 1
Shane Higgins, Consultant Obstetrician 2
1
School of Nursing & Midwifery, Trinity College Dublin, 24 D’Olier
Street, Dublin 2, Ireland.
2 Department of Obstetrics, Our Lady of Lourdes Hospital, Drogheda,
Co-Louth.
Introduction: Preterm birth, defined as birth before 37 completed
week’s gestation, is a major cause of neonatal mortality and
morbidity and continues to pose a major challenge in current
maternity care.
Objectives: To describe and critically analyse practices for
predicting and preventing preterm birth in Ireland and to compare
these practices with the empirical evidence base, international
practices and best practice recommendations.
Design: A quantitative descriptive survey design.
Participants: All consultant obstetricians practising obstetrics in
Ireland at the time of the survey.
Results: The overall response rate to the survey was 68% (n =
68/100). Results were categorised into two groups; women
symptomatic for preterm birth and women asymptomatic for
preterm birth. For predicting preterm birth; 97% and 97% of
respondents did not use fetal fibronectin testing, 71% and 29%
carried out routine 2 nd and 3 rd trimester cervical assessments, and
75% and 44% routinely screened for genital tract infection. For
preventing preterm birth; 62% and 1% prescribed bed rest and
24% and 1% prescribed antibiotics. In women with a history of one
or more mid-trimester miscarriages (15-22 weeks gestation) 14%
of respondents routinely inserted a cervical cerclage. Tocolytic
therapy was routinely used by 61% of respondents for preventing
preterm birth in women symptomatic for preterm birth. The most
common tocolytic agent administered was atosiban (35%).
Conclusions: The findings of this survey, for the most part, reflect
the empirical evidence-base, international practices and best
practice recommendations. There are, however, a number of
practices that do not reflect the empirical evidence base and these
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