Quality statement 1: Providing information about potential signs and symptoms of preterm labour

Quality statement

Pregnant women at increased risk of preterm labour are given information about the potential signs and symptoms.

Rationale

Not all pregnant women at increased risk of preterm labour know what symptoms and signs to look out for. At such a vulnerable time in their lives, women and their families need information about the potential signs and symptoms of preterm labour and the care available that meets their needs and supports shared decision-making, without causing unnecessary anxiety.

Quality measures

Structure

Evidence of local arrangements and clinical protocols to ensure that pregnant women at increased risk of preterm labour are given information about the potential signs and symptoms.

Data source: Local data collection.

Process

Proportion of pregnant women at increased risk of preterm labour who are given information about the potential signs and symptoms.

Numerator – the number in the denominator who are given information about the potential signs and symptoms.

Denominator – the number of pregnant women at increased risk of preterm labour.

Data source: Local data collection.

Outcome

Pregnant women's satisfaction with the information provided.

Data source: Local data collection.

What the quality statement means for service providers, healthcare professionals and commissioners

Service providers (secondary care services) ensure that pregnant women at increased risk of preterm labour are given written information about the potential signs and symptoms by healthcare professionals, who also discuss this with them.

Healthcare professionals (such as midwives and obstetricians) give written information to pregnant women at increased risk of preterm labour about the potential signs and symptoms, and discuss this with them.

Commissioners (clinical commissioning groups) commission services that ensure that pregnant women at increased risk of preterm labour are given written information about the potential signs and symptoms by healthcare professionals, who also discuss this with them.

What the quality statement means for women and their companions

Pregnant women at increased risk of preterm labour (that is, going into labour before the 37th week of pregnancy) are given written information about the signs and symptoms that might suggest preterm labour. A healthcare professional also talks to them about this and the care available.

Source guidance

Definitions of terms used in this quality statement

Pregnant women at increased risk of preterm labour

Pregnant women who:

  • have a history of:

    • spontaneous preterm birth

    • preterm prelabour rupture of membranes

    • mid-trimester loss

    • cervical trauma (including surgery – for example, previous cone biopsy [cold knife or laser], large loop excision of the transformation zone [LLETZ – any number] and radical diathermy)

  • are considered to be at risk of preterm labour and birth because they have a short cervix (less than 25 mm) that has been identified on a transvaginal ultrasound scan and/or bulging membranes in the current pregnancy

  • have preterm prelabour rupture of membranes (P-PROM).

[Adapted from the NICE full guideline on preterm labour and birth]

Information

Pregnant women should be given oral and written information, and be directed to organisations that can provide further support.

[Adapted from the NICE full guideline on preterm labour and birth]

Potential signs of preterm labour

Potential signs could include:

  • watery, mucosal or bloody vaginal discharge

  • regular or frequent (often painless) contractions or uterine tightening

  • P-PROM.

[Expert opinion]

Potential symptoms of preterm labour

Potential symptoms could include:

  • pelvic or lower abdominal pressure

  • constant low, dull backache

  • mild abdominal cramps, with or without diarrhoea.

[Expert opinion]

Equality and diversity considerations

Pregnant women at increased risk of preterm labour should have access to information that is understandable if they:

  • have additional needs, such as physical, sensory or learning disabilities

  • do not speak or read English

  • have religious, ethnic or cultural needs.

Interpreters and advocates should be provided if needed.