OBJECTIVE: Due to the lack of a standardized approach to help prevent p re term delivery in twin gestations, this study is to determine the effectiveness of a specialized care program to prevent preterm deliveries in twin gestations, implemented on a regional and local level. The regional program is designed to facilitate maternal transport into the tertiary care center prior to preterm delivery. STUDY DESIGN: In a one year descriptive study, a ten county region as well as the local city hospital twin pregnancy population received a standardized prenatal care protocol. The protocol included weekly visits from 24 weeks, extensive teaching on symptoms of preterm delivery, use of a contraction log with close monitoring of sexual activity after intercourse, cervical scores by manual exam (length versus dilation) (Newman et al., 1991), ultrasound every 2-4 weeks, wet smears to evaluate the presence of B.V., and consistent care providers. When cervical scores fell below 0, patients were to be sent to the tertiary care site to be observed on an outpatient basis. RESULTS: Of the twenty initial patients enrolled, seven deliveries were to full term twins requiring no intensive care. Five deliveries were to gestational ages 31-35 weeks. Of these infants, none required ventilation and the majority remained in transitional care nursery for observation and weight gain. No very low birthweight babies (< 1500 gms) have been delivered. SUMMARY OF EXPERIENCE AND BARRIERS: Fifty percent of the providers have instituted the protocol as established. Patients have continued to deliver at the smaller rural hospitals, the providers being reluctant to send mothers prior to delivery.
|Original language||English (US)|
|Journal||Acta Diabetologica Latina|
|Issue number||1 PART II|
|State||Published - Dec 1 1997|
ASJC Scopus subject areas
- Internal Medicine
- Endocrinology, Diabetes and Metabolism