‘NICE works’ says Tamba report

By Julie Griffiths on 25 July 2018 Tamba Stillbirth Neonatal Death NICE - The National Institute for Health and Care Excellence

According to a report by the Twins and Multiple Births Association (Tamba), if all maternity units followed NICE guidelines on twin and multiple pregnancies, 55 baby deaths could be prevented every year.

The interim report for Tamba’s Maternity Engagement Programme (MEP) also shows that reducing the number of babies from a multiple pregnancy needing neonatal care could save the NHS in England £3.82m a year.

The findings reveal that many maternity units in England do not have a specialist team experienced in multiple pregnancies. Tamba is calling for multidisciplinary core teams (consisting of a specialist obstetrician, specialist midwife and ultrasonographers, all with experience and knowledge of managing multiple pregnancies) to be present in all maternity units to talk to parents of multiples about the risks of preterm labour and possible outcomes of preterm births by the 24th week of pregnancy.

Tamba CEO Keith Reed said: ‘This report highlights the importance of improved antenatal care for multiple pregnancies and the potential impact upon outcomes if clinical guidance is implemented for our community. 

‘When mums of multiples were able to have a discussion by 24 weeks with a multidisciplinary team about the risks of preterm labour and possible outcome of a preterm birth we can correlate that with a lower stillbirth rate.’ 

Keith said that what’s worrying is that many maternity units do not have such a team in place to begin with and it’s down to ‘pot luck’ if there are healthcare professionals present who are experienced in multiple births. 

‘The figures clearly show the benefits of adopting national clinical guidance of care for families of multiples and supports the national ambition set out by the then health secretary Jeremy Hunt to reduce stillbirths, neonatal deaths and patient safety incidences in maternity services,’ he added.

‘We can safely assume that if all our recommendations were adopted then babies’ lives could be saved,’ Keith said.

During 2017, Tamba's MEP enrolled the participation of 30 maternity units across England, aiming to further explore the antenatal care settings for multiple pregnancies and test whether increased adherence to NICE’s guideline Multiple pregnancy: twin and triplet pregnancies is associated with significantly improved outcomes for our families. 

The findings revealed a correlation between greater adherence to NICE and improved clinical outcomes.

Furthermore, across units of various size and resource, the link between implementation of specific elements of NICE and lower stillbirths, neonatal admissions and neonatal deaths are statistically significant. 

Along with the NICE guidance, Tamba is urging maternity units to access its free multiple-specific CPD resources, a multidisciplinary study day and a peer support unit exchange.

Read the full report here.