What should you know about NICE preterm labour?

Preterm labour is labour that starts before 37 completed weeks of pregnancy. Warning signs can include regular tightenings, period-like cramps, pelvic pressure, a change in vaginal discharge, fluid leaking from the vagina, or unusual lower backache. These symptoms can have other explanations, but a maternity team needs to assess them promptly.

Assessment may include questions about your symptoms, an examination, monitoring contractions and the baby's heartbeat, and tests for cervical change or ruptured membranes. The plan depends on your pregnancy, the findings and how early birth appears to be.

Call your maternity unit or urgent pregnancy service straight away if you have suspected labour symptoms. Note when tightenings began, how often they occur, whether fluid or blood is present, and whether your baby's movements have changed. Do not wait for symptoms to become severe before seeking advice.

Hospital care may include observation, medicines to slow labour in selected situations, and treatment to reduce risks linked with early birth. An antenatal steroid injection may help prepare a baby's lungs when early birth is possible. A cervical cerclage is a separate procedure used in selected pregnancies when the cervix needs additional support.

Seek immediate maternity help for leaking fluid, vaginal bleeding, painful or regular contractions, strong pelvic pressure, fever, severe abdominal pain, or reduced baby movements. If you cannot reach your maternity unit, use emergency services. Bring your pregnancy records if this does not delay leaving.

Ask: Do the findings suggest labour, ruptured membranes, or another cause? How will you monitor me and my baby? Would an antenatal steroid injection or another medicine be appropriate? What symptoms should make me return immediately?