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Antenatal Clinic
Colchester Hospital
Tel: 01206 742 489

Antenatal Clinic
Ipswich Hospital
Tel: 01473 703 102

Preterm Prevention Clinic

What is the preterm prevention clinic?

The clinic provides extra care for women who have a higher risk of spontaneous early preterm (premature) birth (between 24 and 34 weeks of pregnancy) or second trimester miscarriage (pregnancy loss between 14 and 24 weeks of pregnancy). The clinic is led by consultant obstetricians with an interest in preterm birth prevention.

Why have I been referred?

There are a number of reasons or risk factors why your midwife or doctor may recommend that you attend the preterm prevention clinic. These may include:

• previous birth before 34 weeks
• previous late miscarriage after 14 weeks
• waters breaking before 34 weeks in a previous pregnancy
• previous surgery to the cervix (neck of the womb) after an abnormal smear test
• an abnormally shaped womb (sometimes called bicornuate, septated or ‘heart shaped’)
• previous Caesarean section when your cervix was already fully dilated
• you already have a cervical cerclage (stitch) in the neck of the womb

It is important to note that if you have one or more of the above risk factors, it does not necessarily mean that you will have a premature birth or late miscarriage.

What does the preterm prevention clinic do?

The clinic aims to reduce your risk of premature birth or second trimester miscarriage. We will look at what happened in any previous pregnancies and examine the results of the tests you have undergone in clinic, to find out if you are at high risk of early delivery and whether you are likely to benefit from suitable treatment or interventions.

The clinic is held on Tuesday mornings in the antenatal clinic at Colchester Hospital and on Wednesday afternoons at Ipswich Hospital. Often we will see you in the clinic two or more times and then discharge you at around 24 weeks of pregnancy.

Sometimes we need to monitor you more regularly and we may offer you treatments to reduce the risk of preterm birth. We will discuss your individual care plan with you and it will be based on your pregnancy history and the length of your cervix as seen on ultrasound scan. Your plan is unique to you because not every treatment is effective for all patients.

This may be an anxious time for you so we will try to provide you with support and reassurance.

It is important to understand that whilst cervical surveillance and treatment can reduce your risk of preterm birth, sadly not all preterm births or pregnancy loss can be prevented.

What will happen when I visit the clinic?

You will speak to a consultant obstetrician about your history and discuss your personal plan of care.

From 16 weeks of pregnancy onwards you will be offered a vaginal swab test for infection and a transvaginal ultrasound scan of your cervix. The process of a transvaginal ultrasound involves the probe being inserted into the vagina to measure the closed length of the cervix; your bladder should be empty when this takes place.

From 22 weeks onwards you may also be offered a swab test to measure vaginal fetal fibronectin which will help predict your risk of an early birth.

All of the tests you will be offered are safe for you and your baby.

You will be advised of the outcome of your transvaginal scan straight away, but it can take up to one week to receive the results of your swab and urine tests.

What treatment will I be offered?

You may be offered a cervical cerclage, which is a stitch placed within the neck of the womb. A cerclage can be inserted up to 24 weeks into pregnancy but no later. You may also be offered progesterone (hormone) suppositories which are taken until 34 weeks of pregnancy and some
women may be given antibiotics.

When to seek help and advice

Sometimes there are physical signs that you may be going into labour; often these will not result in true labour but it is important that we assess you to make sure.

It is important that you contact your midwife or the labour ward if the following happens:

• you have period–like pains or cramps which come and go
• you are leaking fluid from the vagina
• you have bleeding from the vagina

If you are concerned that you may be in labour, do not wait for your next appointment in the preterm prevention clinic. Call the Colchester Hospital Hotline or Deben (Labour) Ward at
Ipswich Hospital – see telephone numbers below.

Useful sources of information

Tommy’s
Information for parents-to-be
Tommy’s website (Opens in a new window)

Contacts

Colchester Hospital
Antenatal Clinic
Tel: 01206 742 489

Colchester Hospital Hotline
Tel: 01206 345 240

Ipswich Hospital
Antenatal Clinic reception
Tel: 01473 703 102

Ipswich Hospital Deben Ward (labour ward)
Tel: 01473 703 040

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