Tommy's news, 19/04/2018
Current NHS guidelines advise treating all women 30 weeks pregnant and under who present symptoms of threatened preterm labour in the same way, even though many will not go on to deliver early. This means, all of these women experience the same level of additional care, which can be stressful for the women involved, and is unnecessary.
The QUiPP app – used by doctors to help treat patients – takes a number of different factors that affect a woman’s risk of preterm birth, to give a result that shows how likely a woman is to give birth early. This means that care can be focused on the women who need it as they are very likely to give birth early. These factors include:
- A history of previous premature births
- Cervical length measurement (the neck of the womb)
- Level of *fetal fibronectin (a ‘glue’ that binds the amniotic sac to the lining of the uterus).
The new study, EQUIPTT (Evaluation of QUiPP app for Triage and Transfer), has been launched in parallel to the app at 13 obstetric centres across the UK – seven will use the app and six will not.
The study will run for 12 months, after which participants will be invited to give their feedback.
The study aims to recruit 580 women over the next 12 months to look at whether the QUiPP app can reduce the number of women with symptoms of threatened preterm labour being unnecessarily admitted to hospital and given medical interventions.
Chief investigator Professor Andrew Shennan OBE, consultant obstetrician at Guy's and St Thomas' and Professor of Obstetrics at King's College London, said:
“The more accurately we can predict a woman’s risk of preterm birth, the better we can manage a woman's pregnancy to ensure the safest possible birth for her and her baby. It can be difficult for doctors to accurately assess a woman's risk, given that many women who show symptoms of preterm labour do not go on to deliver early.”
Jo Deery, 36 from Margate in Kent, was one of more than 1,000 pregnant women involved in a previous study using the QUiPP app.
The mother of three had seven miscarriages before being referred to St Thomas’ Hospital in 2015. When Jo fell pregnant again she had transabdominal cerclage – a stitch that closes the cervix during pregnancy to help prevent miscarriage or premature birth.
“The doctors used the QUiPP app on me and it turned out that my chance of going into preterm labour again was very very small. I was able to go home and it gave me a brilliant peace of mind. I actually carried my baby son, Cooper, to full term.”Jo Deery
Tommy's chief executive, Jane Brewin is delighted that the app may be able to make pregnancy safer for those women who need additional care, and give reassurance to women who may otherwise be very anxious about their risk:
“Targeting care to women who are at high risk of preterm birth allows precious resources to be focused on helping those with most need whilst giving other parents at low risk, great peace of mind.
This is one of those rare interventions which could give more babies the best start in life whilst saving the NHS money. The initial work looks really positive and it’s now important to check that the same results can be replicated in other hospitals.”
The EQUIPTT study and the QUiPP app both received funding from Guy’s and St Thomas’ Charity, the National Institute for Health Research, Tommy’s Charity and the King’s College London Lion’s Den Health Innovation Prize also helped fund the development of the app.
*What is Fetal fibronectin?
Fetal fibronectin is a special protein made by babies’ cells in the womb, and acts as a 'glue' that keeps the amniotic sac attached to the lining of the womb. If a woman is likely to have a premature birth, the protein is released into the vagina where it can be picked up using a swab.
Tommy’s researchers previously showed that fetal fibronectin should only appear at certain points in pregnancy. During the EQUIPP study, which took place in our London centre, results from over 1,500 women showed that high levels of the protein are directly related to a higher risk of premature birth.
The Tommy’s Preterm Surveillance Clinic
Run by Professor Andrew Shennan, the Tommy’s Preterm Surveillance Clinic at Guy’s and St. Thomas’ Hospital has been providing specialist care to women at risk of preterm birth for over 10 years. Experts state that rolling out this clinic’s model nationally could prevent almost 9,000 premature births each year in the UK. In 2017, the total number of referrals from women at high risk of giving birth too early doubled compared to 2016. We are now seeing an average of 200 referrals each month.
Learn more about Tommy's preterm surveillance clinic.