Preterm Surveillance Clinic

This is a specialist clinic which monitors and treats woman who are at higher risk of spontaneous early preterm (premature) birth between (24 and 34 weeks of pregnancy) or late miscarriage (pregnancy loss between 14 and 24 weeks pregnancy). The clinic is led by obstetric consultant Ms Hoveyda.

Why have I been referred to the clinic?

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 deliveries or late miscarriage before 34 weeks
• premature rupture of the membranes (bag of waters) in a previous pregnancy
• previous surgery to the cervix (neck of womb) after an abnormal smear
• a short cervix found during a scan in this or a previous pregnancy.
• an unusually shaped or abnormal womb (uterus)
• you have a cervical cerclage (stitch around the neck of your womb)

What does the preterm surveillance clinic do?

Its aim is to reduce your chance of premature birth or second trimester miscarriage. We look at your previous history and the results of the tests you have in the clinic to find out if you are at high risk of preterm labour and whether you are likely to benefit from treatment or an intervention. Sometimes we may think it is useful to monitor you more regularly and we may be able to offer you treatments that reduce the risk of preterm birth.

Appointments in the clinic

The preterm surveillance clinic is held every Thursday morning in Clinic 22 within the Rosie Hospital. The phone number for this clinic is 01223 217660.

What will happen when I visit the clinic?

• You will usually speak with a doctor who will ask about your history and discuss your personalised plan of care. Not all treatments are appropriate or effective for all patients.
• You may be offered 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 second trimester miscarriage or premature birth.
• We may take a urine test and/or a vaginal swab (taken using a speculum) to check for infection because some infections can make a second trimester miscarriage or premature birth more likely.
• Emergencies and unexpected events can increase waiting times. We appreciate your patience and will keep you informed if delays occur.

Do the tests have any risks?

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

How often do I need to come to the clinic?

One of our team will discuss this with you at your first visit but we see most patients about every two weeks between 14 and 24 weeks of pregnancy.

If the results of the monitoring up until you are 24 weeks pregnant suggest that you are not at high risk of having your baby before 34 weeks, we will discharge you from the clinic.

You will then see your midwife or obstetrician for follow-up appointments. If you are among the small number of women who remain at high risk, we will continue to monitor you up to 32 weeks of pregnancy.

What treatment will I be offered if I am at high risk of premature birth or late miscarriage?

There are several 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) suppositories which you put into your vagina.
• Antibiotics.
• If you are at high risk after 24 weeks of pregnancy, we may offer. steroid injections to help your baby’s lungs develop.

Please contact us immediately and speak to a midwife if you are experiencing any of the following symptoms:

• Either a slow trickle or a gush of clear or pinkish fluid from your vagina or any increase in vaginal discharge.
• Backache.
• Cramps like strong period pains.
• A frequent need to urinate.
• A feeling of pressure in your pelvis.
• Nausea, vomiting or diarrhoea.
• Contractions more often than every 10 minutes.
• Strong pain, a smelly discharge or bleeding from your vagina.
• Feeling feverish, sick or have a temperature.

Contacts

Clinic 23/Delivery Unit: 01223 217 217