The healthcare challenge
One per cent of all births are pre-term (before 30 weeks) – 10 per cent of these babies have cerebral palsy. Although survival rates for premature babies have improved, the number with cerebral palsy continues to increase. Cerebral palsy affects around 2.5 babies per 1,000 a year in the UK – locally, this means 75 babies per year.
Solution/outcomes to date
Prevention of Cerebral Palsy in PreTerm Labour – or PReCePT, for short – has been developed from a proposal by Dr Karen Luyt, consultant neonatologist at University Hospitals Bristol to increase the use of magnesium sulphate (MgSO4) as a treatment to protect the brain in pre-term babies, ultimately making it a standard practice in local hospitals.
Magnesium sulphate has been proved to reduce the risk of developing cerebral palsy in pre-term babies by around 50 per cent. However, although the cost is only £1 per treatment, only 30 per cent of eligible mothers receive magnesium sulphate. In the UK, if all mothers of at-risk babies could be treated, we could prevent five babies each year from developing cerebral palsy in the West of England alone.
Support from the West of England AHSN
In August 2014, the PReCePT project went live in three trusts: Royal United Hospitals Bath NHS Trust; Gloucestershire Hospitals NHS Trust; and North Bristol NHS Trust. The three Project Midwives leading on the project were charged with developing a baseline audit, developing a training plan and putting in place a timeline for delivery.
Standard patient pathway guidance for the management of suspected pre-term labour has been developed. For clinicians, an information pack has been produced that will enable increased use of magnesium sulphate and support improved data capture on maternity unit databases.
Other materials created include a patient information leaflet detailing when magnesium sulphate may be appropriate as a treatment and a visual prompt for staff to identify patients where the use of magnesium sulphate as a neuroprotector may be appropriate.