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Am J Perinatol 2010; 27(3): 241-249
DOI: 10.1055/s-0029-1239491
© Thieme Medical Publishers

Use of Progesterone Treatment for the Prevention of Recurrent Preterm Birth: Identification of Obstacles to Change

Arianne C. Lim1 , Astrid Goossens2 , Anita C.J Ravelli3 , Kees Boer1 , Hein W. Bruinse4 , Ben Willem J Mol1
  • 1Department of Obstetrics and Gynecology, Academic Medical Centre, Amsterdam
  • 2Department of Quality and Process Innovation, Academic Medical Centre, Amsterdam
  • 3Department of Medical Informatics, Academic Medical Centre, Amsterdam
  • 4Department of Obstetrics and Gynecology, University Medical Centre, Utrecht, The Netherlands
Further Information

Publication History

Publication Date:
12 October 2009 (online)

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ABSTRACT

Progesterone treatment has proven to be effective in preventing recurrent preterm birth. The use of progesterone varies widely between different obstetric clinics in the Netherlands. The study aimed to identify factors that hamper or facilitate the use of progesterone to create an implementation strategy. A Web-based survey was developed containing questions on sociopolitical factors, organizational factors, knowledge, and attitude. This survey was spread among 212 gynecologists, 203 midwives, and 130 women with a recent preterm birth. Response rates were 46% for gynecologists, 57% for midwives, and 78% for patients. Twenty-five percent of gynecologists were prescribing progesterone, 21% of midwives would recommend progesterone, and 54% of patients were willing to undergo treatment in future pregnancies. Specific factors hampering implementation for gynecologists were working in nonteaching hospitals and absence of progesterone treatment in local protocols. For midwives and patients, unfamiliarity with progesterone was the most notable finding. The major reason for failure of implementation of progesterone treatment to prevent recurrent preterm birth is absence of this treatment in protocols and lack of familiarity with this treatment in midwives and patients. This may be overcome through adjustment of clinical protocols on regional and national levels.

KEYWORDS

Preterm birth - progesterone - prevention - implementation

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Arianne C LimM.D. 

Academic Medical Centre, Department of Obstetrics and Gynecology

PO Box 22700, 1105 DE Amsterdam, The Netherlands

Email: A.C.Lim@amc.nl

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