What it is
A table-based decision tool for managing suspected preterm labour with intact membranes. Clinical findings — cervical dilation, contraction frequency, cervical length, and biomarker result — are mapped directly to a management category from the PTL algorithm table. A separate transfer likelihood is shown for non-tertiary settings. If membranes are ruptured, the PPROM pathway is indicated.
How to use
- Confirm membranes are intact — if PPROM is present, the algorithm redirects to that protocol.
- Select your setting: Tertiary or Non-tertiary.
- Select available data: Clinical only, + Cervical Length, or + CL + Biomarker.
- Enter dilation, contraction frequency, and (if applicable) CL and biomarker result.
- The management recommendation updates immediately.
What to expect
One of four management categories: Reassurance, 2-hour observation, Admission, or Admission/treatment. For non-tertiary settings, a transfer likelihood is also displayed: transfer unlikely, transfer likely, or transfer indicated.
Evidence basis
Derived from the PTL algorithm (PTL_algorithm.pptx), a structured decision table for symptomatic preterm labour management.
Consistent with: NICE guideline NG25 — Preterm labour and birth (updated 2022). National Institute for Health and Care Excellence, UK.
Boelig RC, Feltovich H, Berghella V, et al. FIGO good practice recommendations on cervical cerclage for prevention of preterm birth. Int J Gynaecol Obstet. 2021;155(1):19–30. DOI: 10.1002/ijgo.13510