Provision and practice of specialist preterm labour clinics: a UK survey of practice.

OBJECTIVE

To identify the current status of specialist preterm labour (PTL) clinic provision and management within the UK.

DESIGN

Postal survey of clinical practice.

SETTING UK POPULATION

All consultant-led obstetric units within the UK.

METHODS

A questionnaire was sent by post to all 210 NHS consultant-led obstetric units within the UK. Units that had a specialist PTL clinic were asked to complete a further 20 questions defining their protocol for risk stratification and management.

MAIN OUTCOME MEASURES

Current practice in specialist preterm labour clinics.

RESULTS

We have identified 23 specialist clinics; the most common indications for attendance were previous PTL (100%), preterm prelabour rupture of membranes (95%), two large loop excisions of the transformation zone (95%) or cone biopsy (95%). There was significant heterogeneity in the indications for and method of primary treatment for short cervix, with cervical cerclage used in 45% of units, progesterone in 18% of units and Arabin cervical pessary in 5%. A further 23% used multiple treatment modalities in combination.

CONCLUSIONS

A significant heterogeneity in all topics surveyed suggests an urgent need for networking, more evidence-based guidelines and prospective comparative audits to ascertain the real impact of specialist PTL clinics on the reduction in preterm birth and its sequelae.