title: Provision and practice of specialist preterm labour clinics: a UK survey of practice.
abstract: OBJECTIVE
  To identify the current status of specialist preterm labour (PTL) clinic provision and management within the UK.
  
  
  METHODS
  Postal survey of clinical practice.
  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.
  
  
  METHODS
  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.
authors: Department of Women and Children's Health Research, University Department, Liverpool Women's Hospital, Liverpool, UK.
authors: A N
authors: AN
authors: Sharp
authors: Z
authors: Z
authors: Alfirevic
mesh_terms: D023802:Cerclage, Cervical / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007752:Obstetric Labor, Premature / Q000628:therapy*; D009774:Obstetrics / Q000379:methods / Q000458:organization & administration* / Q000706:statistics & numerical data; D010570:Pessaries / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods / Q000458:organization & administration* / Q000706:statistics & numerical data; D011374:Progesterone / Q000627:therapeutic use; D011372:Progestins / Q000627:therapeutic use; D012017:Referral and Consultation / Q000706:statistics & numerical data; D013038:Specialization / Q000706:statistics & numerical data*; D013222:State Medicine; D006113:United Kingdom
chemical_list: D011372:Progestins; D011374:Progesterone
keywords: Cerclage; cervix; preterm birth; specialist antenatal clinic; transvaginal ultrasound