The Pre-term Prevention Clinic

This leaflet aims to explain to you why you have been invited to an appointment in the Pre-term Prevention clinic and what will happen there.

Every year in the UK, about 8 out of 100 babies are born preterm. This means before 37 weeks of pregnancy. Most of these babies do very well, but some especially those born very early will need a lot of extra care.

Some early births are completely unexpected, but some women will have risk factors that we can identify during pregnancy. The information you gave your midwife at your pregnancy booking appointment suggests that you may have a risk factor for your baby being born early. This could be something that happened in a previous pregnancy or birth. It could be related to a health condition or surgery you have had in the past. In this specialist clinic, we will talk to you about how we can reduce this risk or monitor your pregnancy more closely to find any signs of early labour sooner. This may be through a telephone or face-to face appointment initially, usually around 16 weeks into your pregnancy. Sometimes this may be earlier.

Please try not to worry. Most women even with risk factors do not give birth early. The monitoring we offer in this clinic, provides reassurance that all is well. Before you come to this appointment, it might help to visit some of the websites which are listed at the end of this leaflet. These look at some of the options that we may discuss with you to help prevent preterm birth. Here are some of the options that may be discussed:

Cervical length scan
Doing a scan through the vagina allows a measurement of the length of your cervix to be taken. This can help decide how high your risk of early birth is. The scans are not dangerous in any way to you or to your baby. Studies have shown that some women who have early births had a shortening cervix, the neck of the womb, several days or weeks before the birth. Some women will have had similar internal scans in early pregnancy or when having fertility treatment or for other reasons. Most do not find these scans too uncomfortable.

Cervical Stitch
We may talk to you about a cervical stitch. This is sometimes called a suture or cerclage. It is usually done under a light spinal anaesthetic which is an injection in your back that makes your bottom half of your body go numb for a short time. Then we put a stitch around your cervix to try to keep it tightly closed. This is to prevent early birth if you are at higher risk. It does not work for everyone though. The stitch is removed when you are in labour or at 36 weeks, whichever comes sooner. If the stitch is an option for you, we will give you much more information about it and help you decide if you want to have one.

Vaginal Progesterone
Progesterone is a hormone that is important in pregnancy in several ways, including keeping the womb relaxed and lowering the risk of early labour. The treatment involves regularly putting a progesterone pessary into your vagina from 16-36 weeks. It is shaped like a small tampon and most people find it easy to put in.

Infection screening
You may be offered a vaginal examination to allow the doctor to see your cervix. Swabs may be taken to check for infections that could increase your risk of preterm birth.

Additional Information
Please see the resources below for more information on preterm birth and options during pregnancy.

While you have appointments in this clinic, you should also continue with your regular midwife appointments.

You are always free to choose to accept or refuse any appointments, tests or treatments that are offered to you and we are always happy to explain things again if you are unsure or have more questions.

Useful websites
https://www.tommys.org/pregnancy-information/premature-birth
https://www.nhs.uk/pregnancy/labour-and-birth/premature-labour-and-birth/
https://www.bliss.org.uk/