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Preterm Birth Clinic

What is the Preterm Birth Clinic?

This is a specialist clinic which monitors and treats women who might be at a higher risk of preterm (premature) birth (between 24 and 34 weeks of pregnancy) or late miscarriage (16-24 weeks). The clinic is led by a Consultant in fetal medicine and obstetrics.

Why have I been referred here?

You have one or more risk factors for premature birth or late miscarriage in your current pregnancy. These may include:

  • One or more previous preterm births or late miscarriages.
  • Premature rupture of the membranes (bag of water) in a previous pregnancy.
  • Previous surgery to your cervix (neck of the womb).
  • A short cervix found during a scan in this or a previous pregnancy.
  • An abnormally shaped uterus (womb).
  • You have a cervical cerclage (stitch around the neck of your womb).

If you have one or more of these risk factors, it does not necessarily mean you will have a premature birth or late miscarriage.

What does the Preterm Birth Clinic do?

It aims to reduce your chance of pre-term birth or late miscarriage. We look at what happened during your previous pregnancy and the results of the tests you have in the clinic, to find out if you are at high risk of it happening again and whether you are likely to benefit from treatment or interventions. We will discuss your individual care plan with you at your first visit.

You have an individual care plan because not all treatments are appropriate or effective for all women. Your plan includes what may happen if something changes while we are monitoring you. We will also provide you with support and reassurance during what may be an anxious time. It is important to understand that while there is evidence to suggest the monitoring and treatment can reduce your risk, unfortunately not all miscarriages and preterm births can be prevented.

What tests will I have?

We will offer you one or more of these investigations, depending on your risk factors:

  • A transvaginal scan, where we put an ultrasound probe into your vagina to measure the length of your cervix, because a short cervix increases your risk of a late miscarriage or premature birth.
  • A vaginal swab fetal fibronectin (fFN); A negative result on the fFN test means it’s highly unlikely you will give birth in the next week or two, which can set your mind at ease. A positive result does not mean you will give birth early but you are at higher risk of this happening. If you have a positive result your plan of care will be reviewed with you.
  • A urine test and/or a vaginal swab to check for infection, as some infections can make a late miscarriage or premature birth more likely.

Do the tests have any risks?

All of these tests are safe for you and your baby.

What treatment will I be offered if I am high risk of preterm birth or late miscarriage?
There are a number of treatments which we may offer you up to 24 weeks of pregnancy. These include one or more of the following:

  • Cervical cerclage, where a stitch is put around the neck of your womb.
  • Progesterone (hormone) pessaries which you put into your vagina.
  • Antibiotics to treat any infection.

If you are at high risk after 24 weeks of pregnancy, we may offer you steroid injections to help your baby’s lungs develop.

If you would like to know more about any of these treatments please ask a member of the team for information.

Do I still need to see my midwife or obstetrician while I am coming to this clinic?

You will see a Midwife and Obstetrician at each visit. They will provide all your antenatal care whilst you are coming to the clinic. It is not necessary to make separate appointments unless you would prefer to do this.

Who can I contact with queries and concerns?

Contact the lead consultant for the clinic or one of her team, via the Antenatal Clinic phone number opposite. Your Obstetrician or Midwife may also be able to answer any questions you have about your treatment.