Samitivej Sukhumvit Hospital wins award for its preterm prevention programme

It was given the Clinical Service Initiative of the Year award in the Healthcare Asia Awards.

Preterm labour remains the major cause of perinatal morbidity and mortality. Although a large amount of research has been done, the incidence of preterm birth keeps on rising. To date, there is no effective treatment for preterm labour, and the results are still controversial.

Having identified this particular issue amongst its patients, Samitivej Sukhumvit Hospital started its preterm prevention programme in 2016.

This was done by screening pregnant women who were at high risk for preterm birth using previous history of preterm birth and cervical length measurement by transvaginal ultrasonography.

They were then followed up and treated according to standard antenatal care protocol.

The hospital received the “BDMS President Award” in 2018 for its achievement of dramatically reducing incidents of preterm birth. The incidence of preterm birth less than 37 gestational weeks was decreased by 23% and preterm birth less than 34 weeks was reduced by 53%.

In addition, the incidence of respiratory distress syndrome was reduced by 66.7%. But the programme did not end there.

Data showed that the leading causes of preterm birth were also multiple pregnancies and preeclampsia. The hospital then endorsed a preeclampsia screening and prevention programme together with an adjusted preterm prevention protocol for multiple pregnancies. This was done after Down Syndrome screening.

After the new protocol, the preterm birth rate was further reduced. The incidence of preterm birth before 37 weeks and 34 weeks of gestation decreased by 29.5% and 90.3%, respectively. Respiratory distress syndrome was also reduced by 83.3%.

Samitivej Sukhumvit Hospital also recorded that the proportion of preterm premature rupture of membranes (PPROM) as a cause of preterm birth was dramatically reduced from 40% to 18.6%. Spontaneous preterm birth also reduced from 33.3%-11.6%. Multiple pregnancies (32.6%) and preterm birth due to maternal or fetal indications (37.2%) became the major risk factors for preterm birth.

These results demonstrated that its protocol decreased preterm birth through the reduction of spontaneous preterm birth and PPROM.

For this programme, Samitivej Sukhumvit Hospital received the Clinical Service Initiative of the Year – Thailand award in the recently concluded Healthcare Asia Awards.
This year, with its theme of Recognising Trailblazing Initiatives in the Healthcare Sector, the awards programme aims to honour hospitals, clinics, and other healthcare providers that have risen above the challenges and made a remarkable impact on their patients, most especially amidst the massive disruption caused by the COVID-19 pandemic.

This programme showed that Progesterone may reduce inflammation which is one of the main causes of preterm birth and PPROM. The cervical pessary plays a role in supporting the strength of the cervix and also modifies the uterocervical angle. Today, the hospital now endorses universal screening for preeclampsia.

Although multiple pregnancies are associated with preterm birth, most of them were late preterm birth with a very low incidence of neonatal morbidity.

Currently, the incidence of preterm birth in the hospital has successfully been reduced to 5.02%, with only 0.23% born before 34 weeks of gestation. It is committed to continually improving its preterm prevention programme to further reduce preterm birth and its complications.