title: Utilizing new evidence in the prevention of recurrent preterm birth.
abstract: OBJECTIVE
  Treatments that have proven to be effective in large randomized controlled trials are implemented in clinical practice at varying rates. We measured to what extent new and established strategies were applied to prevent recurrent preterm birth in the Netherlands.
  
  
  METHODS
  In two academic hospitals, two non-academic teaching hospitals and two non-academic, non-teaching hospitals, we reviewed charts of all women who had delivered in 2006 and at that time had a history of spontaneous preterm birth before 34 weeks. We compared the application of preventive treatments between different types of hospitals.
  
  
  RESULTS
  Ninety-one records were identified. In academic centers, screening for bacterial vaginosis and progesterone treatment were applied more often than in other centers (49 vs. 14%, p-value 0.001 and 63 vs. 22%, p-value <0.001, respectively). Cervical length measurement was applied more often in non-academic hospitals (58 vs. 39%, p-value 0.07), but with fewer measurements per patient (average of 3.3 vs. 5.8).
  
  
  CONCLUSIONS
  In the management of women with a history of preterm birth, there is large practice variation. Relatively new treatments such as progesterone injections and screening for bacterial vaginosis are applied more frequently in academic centers, whereas cervical length measurement is more often performed in non-academic hospitals.
authors.affiliation: Department of Obstetrics and Gynecology, Academic Medical Centre Amsterdam, the Netherlands. A.C.Lim@amc.nl
authors.forename: Arianne C
authors.initials: AC
authors.lastname: Lim
authors.forename: Astrid
authors.initials: A
authors.lastname: Goossens
authors.forename: Anita C J
authors.initials: AC
authors.lastname: Ravelli
authors.forename: Kees
authors.initials: K
authors.lastname: Boer
authors.forename: Hein W
authors.initials: HW
authors.lastname: Bruinse
authors.forename: Ben Willem J
authors.initials: BW
authors.lastname: Mol
mesh_terms: D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data; D054791:Cervical Length Measurement / Q000706:statistics & numerical data; D055317:Evidence-Based Practice / Q000379:methods; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology / Q000517:prevention & control*; D011296:Prenatal Diagnosis / Q000379:methods / Q000706:statistics & numerical data; D011364:Professional Practice / Q000706:statistics & numerical data; D017584:Reproductive History; D012189:Retrospective Studies; D055502:Secondary Prevention; D016585:Vaginosis, Bacterial / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology