ABSTRACT In 2010, the Australian National Health and Medical Research Council (NHMRC) endorsed Au... more ABSTRACT In 2010, the Australian National Health and Medical Research Council (NHMRC) endorsed Australian and New Zealand clinical practice guidelines that recommend magnesium sulphate to be given to women at risk of imminent, very early preterm birth (at less than 30 weeks gestation) for the prevention of death and cerebral palsy in their infants (The Antenatal Magnesium Sulphate for Neuroprotection Guideline Development Panel 2010). Now, the WISH Project (Working to Improve Survival and Health of babies born preterm), supported by the Cerebral Palsy Alliance, is working to bring Australian and New Zealand clinical practice in line with the recommendations from these guidelines (ARCH 2013).
Background: Babies born very preterm (before 30 weeks gestation) are at high risk of dying in the... more Background: Babies born very preterm (before 30 weeks gestation) are at high risk of dying in their first weeks of life, and those who survive are at risk of developing cerebral palsy in childhood. Recent high-quality evidence has shown that giving women magnesium sulphate immediately prior to very early birth can significantly increase the chances of their babies surviving free of cerebral palsy. In 2010 Australian and New Zealand clinical practice guidelines recommended this therapy. The WISH (Working to Improve Survival and Health for babies born very preterm) Project aims to bi-nationally improve and monitor the use of this therapy to reduce the risk of very preterm babies dying or having cerebral palsy. Methods/Design: The WISH Project is a prospective cohort study. The 25 Australian and New Zealand tertiary level maternity hospitals will be provided with a package of active implementation strategies to guide the introduction and local adaptation of guideline recommendations. Surveys will be conducted at individual hospitals to evaluate outcomes related to local implementation progress and the use and value of the WISH implementation strategies. For the hospitals participating in the 'WISH audit of uptake and health outcomes data collection', the primary health outcomes (assessed through case note review, and 24 month corrected age questionnaires) will be: the proportion of eligible women receiving antenatal magnesium sulphate; and rates of death prior to primary hospital discharge and cerebral palsy at two years corrected age in infants born to eligible mothers. For hospitals wishing to assess factors influencing translation locally, barriers and facilitators will be measured through interviews with health care professionals, to further guide implementation strategies. Study outcomes for the early phase of the project (Year 1) will be compared with the later intervention phase (Years 2 and 3). Discussion: The WISH Project will offer insight into the effectiveness of a multifaceted implementation strategy to improve the uptake of a novel neuroprotective therapy in obstetric clinical practice. The successful implementation of antenatal magnesium sulphate for fetal neuroprotection in Australia and New Zealand could lead to over 90 fewer very preterm babies dying or suffering the long-term consequences of cerebral palsy each year.
ABSTRACT In 2010, the Australian National Health and Medical Research Council (NHMRC) endorsed Au... more ABSTRACT In 2010, the Australian National Health and Medical Research Council (NHMRC) endorsed Australian and New Zealand clinical practice guidelines that recommend magnesium sulphate to be given to women at risk of imminent, very early preterm birth (at less than 30 weeks gestation) for the prevention of death and cerebral palsy in their infants (The Antenatal Magnesium Sulphate for Neuroprotection Guideline Development Panel 2010). Now, the WISH Project (Working to Improve Survival and Health of babies born preterm), supported by the Cerebral Palsy Alliance, is working to bring Australian and New Zealand clinical practice in line with the recommendations from these guidelines (ARCH 2013).
BJOG: An International Journal of Obstetrics & Gynaecology, 2014
Objective To describe the mode and timing of delivery of twin pregnancies at ≥34 weeks of gestati... more Objective To describe the mode and timing of delivery of twin pregnancies at ≥34 weeks of gestation and their association with perinatal outcomes.
ABSTRACT In 2010, the Australian National Health and Medical Research Council (NHMRC) endorsed Au... more ABSTRACT In 2010, the Australian National Health and Medical Research Council (NHMRC) endorsed Australian and New Zealand clinical practice guidelines that recommend magnesium sulphate to be given to women at risk of imminent, very early preterm birth (at less than 30 weeks gestation) for the prevention of death and cerebral palsy in their infants (The Antenatal Magnesium Sulphate for Neuroprotection Guideline Development Panel 2010). Now, the WISH Project (Working to Improve Survival and Health of babies born preterm), supported by the Cerebral Palsy Alliance, is working to bring Australian and New Zealand clinical practice in line with the recommendations from these guidelines (ARCH 2013).
Background: Babies born very preterm (before 30 weeks gestation) are at high risk of dying in the... more Background: Babies born very preterm (before 30 weeks gestation) are at high risk of dying in their first weeks of life, and those who survive are at risk of developing cerebral palsy in childhood. Recent high-quality evidence has shown that giving women magnesium sulphate immediately prior to very early birth can significantly increase the chances of their babies surviving free of cerebral palsy. In 2010 Australian and New Zealand clinical practice guidelines recommended this therapy. The WISH (Working to Improve Survival and Health for babies born very preterm) Project aims to bi-nationally improve and monitor the use of this therapy to reduce the risk of very preterm babies dying or having cerebral palsy. Methods/Design: The WISH Project is a prospective cohort study. The 25 Australian and New Zealand tertiary level maternity hospitals will be provided with a package of active implementation strategies to guide the introduction and local adaptation of guideline recommendations. Surveys will be conducted at individual hospitals to evaluate outcomes related to local implementation progress and the use and value of the WISH implementation strategies. For the hospitals participating in the 'WISH audit of uptake and health outcomes data collection', the primary health outcomes (assessed through case note review, and 24 month corrected age questionnaires) will be: the proportion of eligible women receiving antenatal magnesium sulphate; and rates of death prior to primary hospital discharge and cerebral palsy at two years corrected age in infants born to eligible mothers. For hospitals wishing to assess factors influencing translation locally, barriers and facilitators will be measured through interviews with health care professionals, to further guide implementation strategies. Study outcomes for the early phase of the project (Year 1) will be compared with the later intervention phase (Years 2 and 3). Discussion: The WISH Project will offer insight into the effectiveness of a multifaceted implementation strategy to improve the uptake of a novel neuroprotective therapy in obstetric clinical practice. The successful implementation of antenatal magnesium sulphate for fetal neuroprotection in Australia and New Zealand could lead to over 90 fewer very preterm babies dying or suffering the long-term consequences of cerebral palsy each year.
ABSTRACT In 2010, the Australian National Health and Medical Research Council (NHMRC) endorsed Au... more ABSTRACT In 2010, the Australian National Health and Medical Research Council (NHMRC) endorsed Australian and New Zealand clinical practice guidelines that recommend magnesium sulphate to be given to women at risk of imminent, very early preterm birth (at less than 30 weeks gestation) for the prevention of death and cerebral palsy in their infants (The Antenatal Magnesium Sulphate for Neuroprotection Guideline Development Panel 2010). Now, the WISH Project (Working to Improve Survival and Health of babies born preterm), supported by the Cerebral Palsy Alliance, is working to bring Australian and New Zealand clinical practice in line with the recommendations from these guidelines (ARCH 2013).
BJOG: An International Journal of Obstetrics & Gynaecology, 2014
Objective To describe the mode and timing of delivery of twin pregnancies at ≥34 weeks of gestati... more Objective To describe the mode and timing of delivery of twin pregnancies at ≥34 weeks of gestation and their association with perinatal outcomes.
Uploads
Papers by C. Crowther