Preterm labour — assessment and escalation ⚠️ 🤰
🧠 Clinical mechanism: Premature cervical change and uterine contractions can lead to birth before 37 weeks; risk is strongly influenced by gestational age.
🔎 Recognise
- Contractions, pelvic pressure, back pain, bleeding or suspected fluid loss before term; ask gestation, fetal movements and obstetric history.
🛟 First assessment and action
- Arrange prompt maternity assessment, maternal observations, fetal assessment and senior obstetric/neonatal advice. Discuss transfer to an appropriate neonatal centre where indicated.
🧪 Investigations and reassessment
- Speculum and cervical assessment according to NICE NG25, with specialist-selected tests; assess for membrane rupture and intrauterine infection.
⚠️ Pitfall / escalation
- Do not use a negative single test to override clinical deterioration. Steroids, magnesium sulfate and tocolysis are gestation-dependent specialist decisions.
UK reference: Primary NHS/NICE/RCOG/GMC source.
Editorial draft, 7 November 2026: targeted source-supported educational summary, NOT independent consultant/pharmacist verification or a treatment protocol. Follow up-to-date BNF, NICE and local NHS pathways.
Related: Labour and Complications