Information for before your visit 

Why have I been referred?

Our Preterm Birth Prevention Clinics offer extra care for women who may be at higher risk for preterm (premature) birth. There are several reasons why women may be at higher risk, including if you have experienced any of the following:

• Previous preterm birth.
• Previous prelabour, premature rupture of membranes (water breaking early).
• Previous miscarriage after 16 weeks gestation. 
• Previous cervical surgery including caesarean sections at full cervical dilation.
• Uterine anomalies.
• Shortened cervix seen on ultrasound scan.

We offer the following assessments in the clinic:

• An internal ultrasound scan to assess the length of your cervix.
• A Fetal Fibronectin test which helps us work out your risk for preterm birth.
• A urine test and vaginal swab may be taken to screen for infection.

What will happen when I visit the clinic?

You will see a doctor who will discuss your risks for preterm birth, including information regarding your current and previous pregnancies. All tests offered are safe for you and your baby. 

You will be offered a transvaginal ultrasound scan to measure the length of your cervix. This scan involves a small ultrasound being inserted into the vagina - it requires an empty bladder.

You may also be offered a foetal fibronectin test which helps us to predict your risk for preterm birth. This is done by placing a small swab (like a cotton bud) into the top of the vagina for a few seconds. For the foetal fibronectin test to be reliable, we recommend not engaging in sexual intercourse or vaginal douching for 2 days before your appointment.

What treatments do you offer?

Not everyone who attends the clinic will require treatment. Depending on the initial assessment you may be offered further monitoring and reassurance with repeat ultrasound scans. 

If you are at higher risk of preterm birth, you may be offered vaginal hormone (progesterone) pessaries/tablets. More rarely a stitch around the cervix may be recommended to those at highest risk of preterm birth. 

When to seek advice

Sometimes there are signs that you may be going into labour. Often the signs may not lead to preterm birth, but it’s important to see urgent advice. These signs may include:

• Period-like pains or cramps which come and go.
• Constant back pain.
• Fluid leaking from the vagina.
• Bleeding from the vagina. 

If you think you may be in labour, do not wait for your next appointment. You should call the Central Delivery Suite at Southmead Hospital on the same day. The phone number is on the front of your yellow maternity notes. 

Should I still attend my antenatal appointments?

Yes, you should.

Lifestyle modifications

Many of the risks for preterm birth cannot be changed, however there are some lifestyle changes that can be made where possible.

• Smoking has been associated with preterm birth, and therefore cutting down or stopping smoking is a positive step that can be taken to reduce the risk of your baby being born prematurely. You can speak with your midwife or with the doctor at the preterm birth prevention clinic for advice and ask for a referral for support with giving up smoking. 
• Drinking alcohol during pregnancy has been associated with premature birth. Drinking no alcohol at all is safest. 
• Tooth decay and gum disease has been associated with preterm birth, and therefore it is a good idea to see your dentist, especially if you think you may have tooth decay or toothache. You can organise free dental care with your maternity exemption card.

© North Bristol NHS Trust.  This edition published June 2024. Review due June 2027. NBT003698.