What are the key signs and symptoms of preterm labour that I should assess in a pregnant patient?

Key signs and symptoms of preterm labour to assess in a pregnant patient include:

• Abdominal pain or cramps that may indicate uterine contractions before 37+0 weeks of pregnancy.
• Regular uterine contractions with progressive cervical dilatation from 4 cm, which defines established preterm labour.
• Rupture of membranes before 37+0 weeks (preterm prelabour rupture of membranes, P-PROM), even if labour is not established.
• Other symptoms reported by the woman that might be indicative of preterm labour, such as vaginal discharge or bleeding, although these require clinical assessment to confirm.

Clinical assessment should include history taking, observations as per intrapartum care guidelines, and a speculum examination followed by digital vaginal examination if needed to assess cervical dilatation.

These signs and symptoms warrant prompt evaluation to confirm or rule out preterm labour and guide management.

References: All information is based on NICE guideline NG25 on Preterm labour and birth ¹.