The National Institute for Health and Care Excellence (NICE) has issued an updated quality standard focusing on care for pregnant women who may be at risk of or exhibit signs and symptoms of preterm labour and birth.
The key goals of the quality standard are improvements in the following areas:
- Incidence of preterm births;
- Foetal and neonatal morbidity and mortality;
- Maternal morbidity;
- Neurodevelopmental disabilities; and
- Experience of women giving birth.
The quality standard covers the following six recommendations:
- Pregnant women with an increased risk for preterm labour should be provided with information regarding the potential signs and symptoms.
- Women with a history of preterm birth or mid-trimester loss and a cervical length of ≥25 mm measured between 16+0 and 24+0 weeks of pregnancy should be offered a choice of either prophylactic vaginal progesterone or prophylactic cervical cerclage.
- Women planned to undergo a preterm delivery should be provided with information regarding the risks and potential outcomes.
- Women between 26+0 and 33+6 weeks of pregnancy whose membranes are intact and who are in suspected or diagnosed preterm labour should be offered tocolysis.
- Women between 24+0 and 33+6 weeks of pregnancy in suspected, diagnosed or established preterm labour, with a planned preterm birth or having preterm prelabour rupture of membranes should be offered corticosteroids.
- Women between 24+0 and 29+6 weeks of pregnancy and who are in established preterm labour or are planned to have a preterm delivery within 24 hours should be offered magnesium sulphate.