Pre-pregnancy and pre-term clinic

Pre-pregnancy clinic

West Middlesex

We run a pre-pregnancy clinic twice a month for women who are considering pregnancy and fall into one or more of the following categories:

• Existing health problems which may impact on the pregnancy or present a risk to the future health of the mother
• A child or family member with a health problem which may affect a future baby, including a likelihood of developing the same condition, and the options around this
• A previous difficult pregnancy or a health condition that could recur to plan the type of care that might be required

You will usually be referred to the clinic by your GP or hospital consultant. At your appointment you will be seen by our obstetric consultant Miss Joanna Girling who will ask you ask about your health history and listen to any concerns you have. She will then talk through your options with you. After your appointment a detailed letter will be sent to your referring clinician, including direct contact details if necessary, to help you plan and access further antenatal care.

Pre-term clinic

West Middlesex

The pre-term clinic (PTC) started in 2010 and runs every Thursday in the Obstetric Medicine Clinic. It offers specialised, friendly advice to women who have previously experienced a pre-term birth or late pregnancy loss, or who are at increased risk of pre-term birth. It is run by the ‘H team’ of doctors and midwives and led by consultant obstetricians Miss Joanna Girling and Miss Louise Page.

Most women are offered an appointment with us after their booking appointment, on the basis of their GP’s referral letter or the information given to the midwife at booking. Some women self-refer via the caw-tr.wm-anc@nhs.net email address. This may include women who have had surgical procedures to their cervix, sometimes after an abnormal smear. All requests for appointments are reviewed by one of the consultant obstetricians running the clinic so that the most appropriate care is offered.

At your first appointment we will take a detailed history from you and will try to work out the likelihood of you having a pre-term delivery. If you have any clinic letters about your previous pregnancies or any operations on your cervix, please bring them with you. For some women, the chance of an early delivery is small and we will advise that care during rest of their pregnancy is with their usual team of midwives and doctors. For other women, we may feel that further care within the PTC would be helpful—for example, some women benefit from scans to measure the length of their cervix, some need a cervical suture to be placed and, for others, measurements of fetal fibronectin may be helpful. We usually write a detailed letter to your GP after the first appointment, outlining the plan of care which seems most suitable for you, and give you a copy of this so you have a record of the discussion.

We are actively recruiting women to a variety of national trials looking into pre-term birth, and hope that you will consider taking part if you are eligible.