PReCePT: Reducing cerebral palsy through improving uptake of magnesium sulphate in preterm deliveries
At a cost of £1 per dose of magnesium sulphate to mothers in preterm labour, the PReCePT initiative has prevented seven cases of cerebral palsy in the West of England – an estimated lifetime saving of over £5 million.
PReCePT was developed by the West of England AHSN in collaboration with University Hospitals Bristol NHS Foundation Trust, and involving both patients and staff.
This evidence-based, cost-effective project has been designed to help reduce cerebral palsy in babies through the increased antenatal administration of magnesium sulphate (MgSO4) to mothers during preterm labour, at cost of £1 per individual dose.
Challenge/ problem identified
Cerebral palsy affects approximately 2.5 in every 1,000 babies.It is estimated that the lifetime cost per patient with cerebral palsy, including health care, productivity and social costs, is in the region of €830,000.
NICE recommends administration of magnesium sulphate (MgSO4) in very preterm deliveries as a core part of maternity care to substantially reduce the risk of cerebral palsy by 30%, based on accumulating evidence in support of its brain protective potential.
However, the uptake of MgSO4 in the UK remains relatively low, compared with the rest of the developed world, and this problem applies nationwide (with the exception of a few well-performing maternity units). In the UK in the first quarter of 2017, the National Neonatal Audit programme reported only 39% uptake (3).
Two-thirds of the UK’s preterm babies are not receiving the benefit of this highly cost-effective treatment.
Kruse M, Michelsen SI, Flachs EM, Bronnum-Hansen H, Madsen M, Uldall P. Lifetime costs of cerebral palsy. Developmental Medicine and Child Neurology. 2009;51(8):622-8.
2015 NICE Guideline 25: Preterm labour and birth. National Institute for Health and Care Excellence (Available from: https://www.nice.org.uk/Guidance/NG25)
National Neonatal Audit programme (NNAP) 2017 [Available from: http://www.rcpch.ac.uk/improving-child-health/quality-improvement-and-cl...)
Preventing cerebral palsy in preterm labour (PReCePT) from West of England AHSN on Vimeo.