Preterm birth surveillance clinic
At both Chelsea and Westminster Hospital and West Middlesex Hospital, we provide specialist care to pregnant women who are at higher risk of giving birth to their baby early (before 37 weeks of pregnancy). The clinics are dedicated to enhancing knowledge of preterm birth and establishing an evidence-based approach to care. We support women in their pregnancy by close monitoring in the first two-thirds of pregnancy and providing treatment to try to prevent premature labour. Once women reach 28 weeks of pregnancy most can be discharged and continue their pregnancy care with their midwife, general obstetrician or GP. The comprehensive service offers pre-conceptual counselling, postnatal debrief consultation, a wide range of cerclage and other treatments options and predictive tests.
Prematurity is a major global issue and the most important cause of poor health and development in children and sadly, childhood death. Approximately, one in twelve women (8%) give birth to their baby before 37 weeks of pregnancy. Fortunately, in the majority of cases, the baby arrives just a few weeks early and these babies are generally healthy. However around 1 in 100 (1%) babies are born 10 weeks before their due date or even earlier, and in these cases, the outcome may be very different with complicated health needs if the baby survives. The aim of our clinics is to prevent preterm labour and birth as far as is possible and where not possible to enhance care to reduce the complications of prematurity for your baby.
The service is run by obstetricians who are specialised in looking after women who at higher risk of premature birth, a specialist prematurity midwife, and research midwives and nurses. We also train doctors and student doctors in the clinic.
What will happen in the Preterm Surveillance Clinic?
The Preterm Surveillance Clinic aims to provide extra care for women who may have a higher risk of having a baby born early.
- Most often, you will have 3 to 4 appointments at the clinic. Once the team can reassure you that your pregnancy is progressing well, they will discharge you from the clinic around 26-28 weeks of pregnancy.
- You will usually speak with a doctor who will ask your history and discuss your personalised plan of care.
- You will be offered a transvaginal ultrasound scan of your cervix, where an ultrasound probe is placed into the vagina. Your bladder should be empty for this scan. This examination is safe for you and your baby.
- Whenever necessary, you may also be offered a vaginal swab test (Fetal fibronectin or FFN) to help predict your risk of an early birth. This is done with a speculum and then a swab (like a cotton bud) is placed in the vagina for a few seconds. Your swab result is usually ready after 15-30 minutes. It is important that you have not had sex or an internal vaginal examination in the 24 hours prior to a fetal fibronectin test.
- The comprehensive service offers pre-conceptual counselling, a wide range of cerclage and other treatments and predictive tests.
It is important that you attend any other antenatal appointments you may have in addition to visiting the Preterm birth Surveillance Clinic – the member of the team you see will let you know if all care can be provided within the Preterm Clinic or if you need additional appointments as well.
Contact information
The Preterm Birth Surveillance Clinics runs every:
- Wednesday afternoon in the Antenatal Clinic Department, 1st floor, Lift Bank B, Chelsea and Westminster Hospital.
- Thursday all day in the Antenatal Clinic Department, Ground floor, Queen Mary Maternity Unit, West Middlesex Hospital.
Chelsea and Westminster Hospital
T: 020 3315 6000
West Middlesex University Hospital
T: 020 8321 5839
Consultants
Chelsea and Westminster Hospital
- Miss Angela Yulia is a Consultant Obstetrician and an accredited Maternal and Fetal Medicine Subspecialist. She is passionate about delivering care that is safe, individualised and evidence-based. She undertook postgraduate clinical training in Obstetrics and Gynaecology in multiple renowned centres across the UK including Newcastle Upon Tyne and London. She completed subspecialty training in Maternal and Fetal Medicine at University College London Hospital. She was awarded a PhD from Imperial College London in 2015. Her research is re-shaping our approach to the management of preterm labour with the introduction of new treatment modalities to reduce its incidence.
- Dr Vasso Terzidou is a Consultant Obstetrician and Gynaecologist at Chelsea and Westminster Hospital, a member of the high-risk pregnancy team, and a Reader (Associate Professor) in Obstetrics and Gynaecology at Imperial College, London. She is a clinical academic in Obstetrics with an international reputation for the prediction and prevention of preterm birth. Vasso set up the specialised prematurity clinic at Chelsea & Westminster in 2011 to offer high level obstetric monitoring and care for women at risk to deliver preterm. She provides continuity of care in a nurturing environment, manages women with comprehensive services, offers all types of cerclage treatments and applies evidence-based approaches and predictive tests for preterm labour. Her clinical and scientific work has helped to establish the first European March of Dimes Prematurity Research Center. This represents a partnership between Imperial College, Chelsea & Westminster Hospital, Queen Charlotte’s Hospital and St Mary’s Hospital and demonstrates the commitment of accomplished clinicians and scientists as they come together to enhance knowledge, understand the causes, and best treatments for preterm birth.
West Middlesex University Hospital
- Miss Joanna Girling set up the preterm Birth Clinic at West Middlesex University Hospital in 2009. She has been a Consultant Obstetrician for over 20 years and her clinical interests in addition to prematurity include Obstetric Medicine and clinical research. She has a number of regional and national roles including Clinical Director for NW London Maternal Medicine Network, Assessor with MBRRACE (Mothers and Babies reducing Risk through Confidential Enquiry), Specialty Committee member for National Institute for Health and Care Excellence (NICE), NW London Clinical Research Network Speciality Lead for Reproductive Health and Childbirth.
- Miss Samantha Steele is a Consultant Obstetrician who specialises in maternal medicine, preterm birth and safety in maternity. She graduated in medicine from Imperial College and has undertaken specialist training and worked in Obstetric units across North West London for more than 15 years. In addition she holds a BSc in Reproductive Medicine and specialist training awards in maternal medicine and advanced labour ward practice. She is actively engaged in recruiting patients to multicentre research studies particularly those to further understanding and management of preterm birth. She has also held a national role in development of maternity policy through the maternity transformation programme, maternity safety incentive scheme and preventing preterm birth as part of the Saving Babies Lives care bundle.
Prematurity Lead Midwife
Chelsea and Westminster Hospital
- Joanna Chilvers is the Preterm Birth Clinical Research Team Leader at Chelsea and Westminster Hospital. Within this role, she is jointly responsible for both supporting the aims of the Trust Research Strategy within maternity as well as supporting the implementation of the Saving Babies Lives Care Bundle in the prediction, prevention and preparation for preterm birth. Joanna has worked across all areas of the maternity unit at Chelsea and Westminster over the last 8 years, including as the Antenatal Ward Lead Midwife and within the Quality and Safety team. Joanna has a keen interest in preterm birth and works alongside the lead Consultants to ensure the service provides women with evidence-based, individualised care.