Implementation protocol for a treatment bundle targeting modifiable risk factors for preterm birth

Authors:
Open Access
Publisher website
Google Scholar
Abstract
Preterm birth (PTB) is the main cause of perinatal and neonatal morbidity and mortality worldwide. Widespread implementation of guidelines for early identification and management of patients at risk for adverse pregnancy outcomes is still feeble. This work aims to implement a simple and low-cost bundle to access and manage major modifiable risk factors for PTB. We included first trimester pregnant women seen at Health Units from Jaú - SP, Brazil, where PTB prevalence ranges from 13,4% to 18%. The protocol is based on three aspects: a questionnaire to access smoking status and clinical history; Gram staining and of vaginal microbiota evaluation using Nugent's criteria and evaluation of cervical infections; and transvaginal ultrasound. Pregnant women who smoke and are willing to quit will be treated with auricular acupuncture and referred to a support group if necessary. All patients will be advised on intimate hygiene habits, and those with dysbiosis will be treated. Cervical length will be accessed using transvaginal ultrasound, and those diagnosed with cervical shortening will be treated with vaginal progesterone. This study highlights the importance of implementing active measures to reduce PTB risk factors in a high prevalence setting.
Funding Information
  • São Paulo Western University

This publication has 11 references indexed in Scilit: