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PReCePT – Preventing cerebral palsy in pre-term labour

Babies who are born prematurely (less than 30 weeks gestation) are at more risk of developing cerebral palsy. There is growing evidence that giving magnesium sulphate (MgSO4) to mothers before birth can protect the brain during premature labour and birth (see links to papers below). For every 37 mothers who receive magnesium sulphate one case of cerebral palsy can be prevented.

The West of England Academic Health Science Network (AHSN) ran a quality improvement project in 2014 to raise the profile of magnesium sulphate as a neuroprotector. Over the course of six months five maternity units increased the administration of MgSO4 to eligible mothers from an average baseline of 21% in the two years preceding the project to 88%. Read the evaluation.

As part of the new licence for AHSNs (Now renamed Health Innovation Networks) in 2018, NHS England commissioned a number of national programmes for implementation across all 15 AHSNs. One of these was Preventing Cerebral Palsy in Preterm Labour (PReCePT) – a multi-organisational quality improvement approach to the adoption and spread of MgSO4.

The aim was to reduce the number of very preterm babies born with cerebral palsy by increasing the uptake of MgSO4 in eligible mothers to 85% or more. The programme ran from 2018 to 2020. The national project’s achievements over this period included:

+ an extra 1,106 mothers receiving magnesium sulphate

+ an estimated 30 cases of cerebral palsy avoided

+ increasing the number of maternity units adopting MgSO4 from five to 156

+ estimated savings of £23.9m in lifetime health and social care costs

Thames Valley PReCePT teamPReCePT Thames Valley was delivered by midwives overseen by Dr Mark Anthony, Regional PReCePT Lead, along with the Oxford Patient Safety Collaborative, part of the Oxford AHSN, and representatives from all maternity units in Berkshire, Buckinghamshire, Oxfordshire and Milton Keynes. One of the PReCePT champions was Claire Edward-Few, Practice Development Midwife at Buckinghamshire Healthcare. She said: “We had some great support from the Oxford AHSN … We were able to meet with other regional champions in our area. We could use other people’s ideas, put all our heads together and come up with things that were bigger and better and improved outcomes.”

During the first nine months of 2020 the Thames Valley uptake rate averaged 92% – well above the 85% target – and hit 100% in October and November.

The video at the top of the page shares the local story of Jennie and Richard whose twin boys were born prematurely. Jennie received magnesium sulphate during her preterm labour.