Premature labour

1 in 13 babies are born prematurely (before 37 weeks) in the UK.  If you start showing signs of labour before 37 weeks you will need to ring our triage department as soon as possible and come in to be assessed.  Early labour signs can include:

• Your waters breaking
• Abdominal pain
• Regular tightenings
• Vaginal blood loss

Our special care baby unit in Hereford can provide care for babies who are 32 weeks and above. Therefore if you were to go into labour before this then a transfer to an appropriate unit would be organised as a matter of urgency.

Once in triage a full assessment will be carried out to determine whether your labour may be starting, this will include:

• A full set of observations
• A CTG monitoring of baby (if you are 26 weeks or more)
• A speculum examination where a swab will be taken which gives a percentage chance of whether you are likely to go into labour within the next week, this result only takes 10 minutes or so. If you are contracting regularly you may be offered a vaginal examination to see if your cervix is starting to open
• A swab called a ROM+ if you think your waters may have broken
• A ultrasound scan to determine baby’s position

If the result shows that the chance of you going into labour is low then you will be able to go home. If it is looking like you may go into labour imminently or are in labour there are a number of actions we will take:

• Administer a steroid injection to help with the development of your baby’s lungs
• Give you a medication called Nifedipine or Atosiban which aims to slow down or stop contractions
• Magnesium Sulphate IV drip – this helps to protect baby’s brain and is known to protect against cerebral palsy
• IV antibiotics
• A Consultant Paediatrician will come and discuss the plan of care for baby once they are born

Late pre term babies (babies born between 34 and 36+6 weeks and babies who weigh under 2.5kg at birth, are shown to be more at risk of being re-admitted to hospital due to factors such as jaundice, problems with feeding, sepsis and respiratory concerns. Therefore it is recommended that these babies remain in hospital care for 72 hours before being discharged home.