Preterm birth is the leading cause of neonatal mortality and morbidity, with more than one-third of deaths during the first year of life being attributed to preterm related causes. The associated emotional and economic costs to families and the economic burdens to hospitals and payers are overwhelming.
Preterm labor Assessment
- The Oklahoma Perinatal Quality Improvement Collaborative is working with perinatal care providers and birthing hospitals to ensure that all hospitals practice a standardized evaluation of women who present with signs and symptoms of preterm labor and to increase the number of women at risk for preterm birth who receive progesterone.
- In response to variations in practices reported in the literature and the absence of consistent standards for triaging women presenting with preterm uterine contractions, the March of Dimes, partners, and co- authors developed the Preterm Labor Assessment Toolkit (PLAT). Download your free copy today. Registration is required, as the March of Dimes wants to keep track of downloads.
- The Preterm Birth Initiative in Oklahoma is working to ensure that all birthing hospitals have direct access to fetal fibronectin testing and transvaginal ultrasound as recommended in the March of Dimes Preterm Labor Assessment Toolkit. A recent survey of Oklahoma birthing hospitals shows that a standardized process is only used consistently in about 25% of these hospitals. The Oklahoma Perinatal Quality Improvement Collaborative will work with Oklahoma birthing hospitals, the March of Dimes, Hologic, payers and other partners to remove barriers in implementing a standardized process for the evaluation of preterm labor.
Oklahoma Progesterone Project
- The prophylactic administration of progesterone to women with a singleton pregnancy and a history of a spontaneous preterm birth has been shown to reduce the rate of recurrence. ACOG recommends the use of progesterone supplementation starting at 16-20 weeks to prevent recurrent preterm birth for these women. ACOG also recommends vaginal progesterone for asymptomatic women with a singleton gestation without a prior preterm birth with an incidentally identified cervical length of < 20 mm at ≤ 24 weeks gestation.
- OHCA Progesterone Guidelines v1.0 9-16
Cervical Length Measurement
- The Office of Perinatal Quality Improvement received grant funding from the March of Dimes for appropriate Oklahoma providers. The March of Dimes funding supported the training of 71 Oklahoma clinicians at no cost. Many thanks to the March of Dimes for their generous support. You can still sign up for the Perinatal Quality Foundation’s Cervical Length Education and Review (CLEAR) program by clicking here but you will be required to pay the full price for the course.
Makena® and Vaginal Progesterone Coverage: OHCA Provider Letter (includes Progesterone algorithm and Progesterone Coverage Chart)
- OHCA Forms: PHARM 23 (prior authorization form)
March of Dimes Preterm Labor Assessment Toolkit Registration is required.