Health professionals play an important role in the prevention of preterm and early term birth.
Early antenatal care
It’s important to undertake an early pregnancy assessment to identify women at risk of preterm and early term birth.
Planned birth at less than 39 weeks gestation should be reserved for medical or obstetric indications. Refer to the Preterm Labour and Birth Prevention (PDF 2.21MB) and the Diagnosis and Management Perinatal Practice Guideline (PDF 1.53MB).
Omega-3 screening
Omega-3 screening should be offered as part of the SA Maternal Serum Antenatal Screening Program (SAMSAS) and supplementation should be recommended for low Omega-3 levels.
Smoking and vaping
Women who smoke or vape should be provided with appropriate assessment and cessation interventions, including assessment for nicotine replacement therapy. Refer to the Smoking (Tobacco) and Vaping in Pregnancy Perinatal Practice Guideline (PDF 1.22MB).
Mid-pregnancy scan
All women should have the length of their cervix measured at their mid-pregnancy scan (18 to 20 weeks).
Women at high risk of preterm birth should have increased transvaginal cervical length monitoring from 16 to 24 weeks under the supervision of a preterm birth clinic or high-risk obstetric care service. Refer to the Cervical Length (short) and Cerclage Perinatal Practice Guideline (PDF 1.84KB).
Natural vaginal progesterone should be prescribed as soon as a short cervix is detected (less than 25mm on transvaginal ultrasound). If the cervix continues to shorten, pregnant women should be referred to a preterm birth clinic or high-risk obstetric care service for consideration of a cervical cerclage.
Continuity of care
Wherever possible, women should have the opportunity for continuity of carer (seeing the same or a small group of carers) and/or continuity of care (a coordinated, collaborative approach among all professionals involved), particularly when care is complex.
Evidence shows that women in midwifery-led continuity of care models report higher satisfaction, greater autonomy and choice, and lower stress and anxiety compared to other care models. Refer to the Antenatal Care Routine Care in Normal Pregnancy Perinatal Practice Guideline (PDF 1.53KB).
Consumer and promotional information
Refer pregnant people to the consumer web page and the following resources:
- All the ways to reduce your risk of chance of preterm birth (PDF 12MB)
- Start maternity care early (PDF 1MB)
- Continuity of care (PDF 316KB)
- Smoking and vaping in pregnancy (PDF 1MB)
- Every week counts in the final weeks of pregnancy (PDF 352KB)
- Mid-pregnancy scan (PDF 1MB)
- Safe pregnancies are everyone's business (PDF 852KB)
Fact sheets are available to assist in your discussions with pregnant people.
- cervical length ultrasound fact sheet (PDF 1727KB), also see translated fact sheets below
- vaginal progesterone fact sheet (PDF 2309KB), also see translated fact sheets below
-
omega-3 screening to help prevent premature births (PDF 365KB)
- pregnancy after having a premature baby fact sheet (PDF 1517KB)
- babies born 20-22 weeks gestation fact sheet (PDF 446KB)
- babies born 23-24 weeks gestation fact sheet (PDF 486KB)
- babies born 25 weeks gestation (PDF 500KB)
Arabic
Chinese simplified
- cervical length in Chinese simplified (PDF 2142KB)
- vaginal progesterone in Chinese simplified (PDF 2356KB)
Dari
Farsi
Hazaragi
Vietnamese
Pitjantjatjara translated audio
Clinical tools
Sonographer tools and resources
For sonographers and sonologists performing cervical length ultrasounds and escalating care for women with a short cervix.
- Cervical length quick measurement guide (PDF 429KB)
- Cervical length ultrasound pathway and follow up (PDF 346KB)
- Cervical Length Ultrasound Screening webinar
Perinatal Practice Guidelines relating to preterm and early term birth
There are a number of Perinatal Practice Guidelines that directly relate to preterm and early term birth prevention and management, these are:
- Cervical length and cerclage Perinatal Practice Guideline (PDF 1.84MB)
- Preterm labour and birth: Prevention, diagnosis and management Perinatal Practice Guideline (PDF 2.21MB)
- Induction and Augmentation of Labour Perinatal Practice Guideline (PDF 2.63MB)
- Preterm Prelabour Rupture of Membranes Perinatal Practice Guideline (PDF 1.38MB)
- Prelabour Rupture of the Membranes (PROM) greater than 37 weeks Perinatal Practice Guideline (PDF 1.88MB)
- Magnesium Sulphate for Neuroprotection of the Fetus in Women at Risk of Preterm Birth Perinatal Practice Guideline (PDF 715KB)
- Perinatal Care at the Threshold of Viability Perinatal Practice Guideline (PDF 596KB)
Refer to individual Perinatal Practice Guidelines for management of obstetric and medical indications for preterm birth.
Educational videos on preterm and early birth prevention
The SA Health Preterm Birth Prevention Project team hosted a series of educational webinars. Find links to the recordings below:
- Preterm Birth Prevention — Proven strategies to reduce preterm and early term birth. Presented by Dr. Kate Andrewartha
- The role of the midwife — The scope of midwifery practice in preterm birth prevention. Presented by RM Bel Nitschke.
- Timing of birth — Recommendations for timing of birth and implications of early term birth with no medical or obstetric indication. Presented by Dr. Kate Andrewartha.
- Management of Preterm birth — For metro and regional settings. Presented by Dr. Kate Andrewartha.
- Smoking and vaping in pregnancy: A clinician’s approach in cessation support — Support women to quit smoking and vaping during pregnancy. Presented by RM Bel Nitschke
- Early onset pre-eclampsia: Screening and prevention — Recommendations for screening and management. Presented by Dr. Aimee Woods.
- Omega-3 status test for prematurity risk — The SAHMRI Omega-3 Test and Treat program.