The use of specialised preterm birth clinics for women at high risk of spontaneous preterm birth: a systematic review
| العنوان: | The use of specialised preterm birth clinics for women at high risk of spontaneous preterm birth: a systematic review |
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| المؤلفون: | Katie M. Groom, Vanessa Jordan, Lisa Dawes, Jason Waugh |
| المصدر: | BMC Pregnancy and Childbirth BMC Pregnancy and Childbirth, Vol 20, Iss 1, Pp 1-15 (2020) |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Adult, medicine.medical_specialty, Outpatient Clinics, Hospital, Referral, medicine.medical_treatment, Pregnancy, High-Risk, Psychological intervention, Reproductive medicine, MEDLINE, CINAHL, lcsh:Gynecology and obstetrics, Specialised preterm birth clinic, 03 medical and health sciences, 0302 clinical medicine, Clinical Protocols, Pregnancy, Outcome Assessment, Health Care, medicine, Secondary Prevention, Humans, Cervical cerclage, 030212 general & internal medicine, lcsh:RG1-991, 030219 obstetrics & reproductive medicine, Fetal fibronectin, Obstetrics, business.industry, Infant, Newborn, Pregnancy Outcome, Obstetrics and Gynecology, Gestational age, Preterm birth prevention clinic, Perinatal Care, Spontaneous preterm birth, Cervical Length Measurement, Premature Birth, Female, business, Research Article |
| الوصف: | Background Specialised preterm birth clinics care for women at high risk of spontaneous preterm birth. This systematic review assesses current practice within preterm birth clinics globally. Methods A comprehensive search strategy was used to identify all studies on preterm birth clinics on the MEDLINE, Embase, PsycINFO, CENTRAL and CINAHL databases. There were no restrictions to study design. Studies were limited to the English language and publications from 1998 onwards. Two reviewers assessed studies for inclusion, performed data extraction and reviewed methodological quality. Primary outcomes were referral criteria, investigations and interventions offered in preterm birth clinics. Secondary outcomes were the timing of planned first and last appointments and frequency of review. Results Thirty-two records fulfilled eligibility criteria and 20 studies were included in the main analysis following grouping of records describing the same study or clinic. Studies were of mixed study design and methodological quality. A total of 39 clinics were described; outcome data was not available for all clinics. Referral criteria included previous spontaneous preterm birth (38/38, 100%), previous mid-trimester loss (34/38, 89%) and previous cervical surgery (33/38, 87%). All clinics offered transvaginal cervical length scans. Additional investigations varied, including urogenital swabs (16/28, 57%) and fetal fibronectin (8/28, 29%). The primary treatment of choice for a sonographic short cervix was cervical cerclage in 10/33 (30%) clinics and vaginal progesterone in 6/33 (18%), with 10/33 (30%) using multiple first-line options and 6/33 (18%) using a combination of treatments. The majority of clinics planned timing of first review for 12–16 weeks (30/35, 86%) and the frequency of review was usually determined by clinical findings (18/24, 75%). There was a wide variation in gestational age at clinic discharge between 24 and 37 weeks. Conclusions There is variation in the referral criteria, investigations and interventions offered in preterm birth clinics and in the timing and frequency of review. Consistency in practice may improve with the introduction of consensus guidelines and national preterm birth prevention programmes. Trial registration Systematic review registration number: CRD42019131470. |
| تدمد: | 1471-2393 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::28645796e96e71e46e67c3edbf4de85cTest https://pubmed.ncbi.nlm.nih.gov/31996173Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....28645796e96e71e46e67c3edbf4de85c |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14712393 |
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