Preterm Birth Prevention Clinic

You have had a risk assessment at the beginning of your pregnancy that shows you may be at higher risk of premature birth. This may be because of one or more of the following conditions:

• You have had a previous baby or your waters have broken before 34 weeks of pregnancy
• You have lost a baby due to early labour after 16 weeks of pregnancy (mid-trimester loss)
• You have previously had a stitch in your cervix (cervical cerclage)
• You have an unusually shaped womb
• Surgery to the neck of the womb
• You have previously had a caesarean section when your cervix was fully dilated

You may also have been referred to the preterm birth prevention clinic as a result of a previous birth experience.

These factors may slightly increase the risk of your baby coming early, but it does not mean that they definitely will.

• Smoking doubles the risk of you having your baby early. Please speak to your midwife about how we can help you stop smoking. This will also be discussed at the clinic.
• People who experience domestic violence have more chance of having a baby early. Please speak to your midwife so that we can help.
• If you feel like you might have a urine infection, speak to your midwife or GP as soon as possible.
• Sexually transmitted infections (such as chlamydia and gonorrhoea) are associated with having a baby early. We can offer tests for this at the clinic, however if you think you might be at risk of having an STI then speak to your midwife or local sexual health clinic as soon as possible.

Please bring your hand held pregnancy notes to every appointment.

The clinic hopes to reduce the chance of your baby being born early but unfortunately not all late miscarriages and preterm births can be prevented.

You and your doctor will make a personalised plan for your pregnancy depending on your individual pregnancy. This may include:

• Checking for an infection in your urine

• Swabs taken from the vagina
• An internal scan to measure the neck of the womb, sometimes on more than one occasion. Please make sure you have an empty bladder (have just been to the toilet) before your appointment.

Depending on your individual circumstances, possible treatments include:

• Antibiotics
• Hormone (progesterone) pessaries to support the cervix
• A silicone device (cerclage pessary) to support the cervix
• A stitch (cervical cerclage) to support the cervix

Research is an important part of trying to investigate why labour happens early, we may talk with you about trials that are running in the department.

Sometimes there are signs that you may be going in to early labour. Often this does not lead to early labour but it is important to seek advice if you think this is happening to you. Signs may include:

• Fluid leaking from the vagina
• Bleeding from the vagina
• Period pains or cramps
• Lower back ache or a feeling of pressure down below

If you are over 16 weeks pregnant and have any of these of symptoms it is important not to wait for your next appointment. You should contact your midwife or local maternity unit immediately. You should inform them of your symptoms and that you are under the care of the preterm birth prevention clinic.