Late Pregnancy · Preterm Risk
QUiPP App — Preterm Birth Risk
Free clinical app that calculates personalised preterm birth risk from fFN + cervical length + history. NICE-supported decision aid. Informs admission, steroids, magnesium, transfer decisions. EQUIPTT trial 2020.
Last reviewed 2 June 2026
QUiPP App — preterm birth risk algorithm
NICE-endorsed individual risk prediction
This page describes the QUiPP App.
QUiPP is a free, validated, NICE-endorsed mobile app — we don’t replicate the algorithm here because the official app is the canonical implementation. The 5 inputs and what they represent are explained below.
Open quipp.orgThe 5 inputs QUiPP uses
What QUiPP outputs
- Probability of spontaneous preterm birth within 2 weeks of test
- Within 4 weeks of test
- Before 30 weeks gestation
- Before 34 weeks
- Before 37 weeks
Outputs are presented as % risk with confidence intervals; outperforms any single predictor used alone.
Educational tool only — not medical advice. QUiPP App v2 (Carter 2016, Watson 2020) is the NICE-endorsed algorithm for symptomatic and asymptomatic preterm birth risk prediction in the UK. Available free on iOS and Android. The companion fetal fibronectin test and TV cervical length measurement are described in the linked BumpBites pages. Decisions about admission, antenatal steroids, magnesium sulphate, and tocolysis are made by obstetric teams using QUiPP plus clinical context.
What does this mean?
QUiPP changed the conversation around threatened preterm labour. Before QUiPP, units relied on single tests (cervical length OR fFN) with arbitrary cut-offs — useful but with high false-positive rates (many women admitted, steroids given, that didn’t need them). The Bayesian QUiPP model combines GA at test, cervical length, quantitative fFN, prior PTB history, and singleton vs twin into one personalised %-risk number. This identifies the small group at genuinely high risk (who need same-night intervention — antenatal corticosteroids, magnesium for neuroprotection, in-utero transfer to a unit with NICU) and the larger group at low risk who can be sent home with safety-netting. NICE NG25 (2015, updated 2022) endorses QUiPP for both symptomatic and asymptomatic (high-risk surveillance) use. The app is free on iOS and Android — the calculator on this page is descriptive only; your clinician will use the official app.
What is QUiPP?
Free clinical app that calculates preterm birth risk using quantitative fetal fibronectin (qfFN) + cervical length + maternal history. NICE-supported decision aid.
Developed by Andrew Shennan / King’s College London. Used in UK NHS, US, and globally.
What goes in
- Quantitative fFN (qfFN) in ng/mL.
- Cervical length on TVUS in mm.
- Gestational age.
- Parity.
- Previous preterm birth history.
- Symptoms.
- Multiple pregnancy status.
What comes out
Percentage probability of delivery in: 14 days, 30 days, before 30 weeks, before 34 weeks, before 37 weeks.
Clinical decisions it informs
- Admit vs discharge.
- Antenatal steroids if 24-34 wk.
- Magnesium sulphate if <32 wk + imminent.
- In-utero transfer to specialist NICU.
- Tocolysis to delay 48h.
- Routine surveillance schedule.
- Parent counselling.
How accurate?
EQUIPTT trial 2020: QUiPP-guided care reduced unnecessary admissions + interventions vs standard care.
High NPV — low-risk women safely discharged. Moderate PPV — identifies women warranting treatment.
If high risk
- Hospital admission.
- Steroids 24-34 wk.
- Magnesium sulphate <32 wk + imminent delivery.
- Tocolysis 24-48h for steroid effect.
- In-utero transfer if early gestation.
- Intensive monitoring.
If low risk
Reassuring. Safety-net advice; home if otherwise well; follow-up scan / fFN in days-weeks. <1% chance of delivery within 14 days with very low QUiPP.
Alternatives
- PartoSure (PAMG-1).
- Actim Partus (phIGFBP-1).
- Cervical length alone.
- fFN alone.
QUiPP advantages: free, NICE-supported, multimodal.
Different scenarios
Scenario 1: 28 weeks, contractions, QUiPP 18%
Moderate-high. Steroids. Tocolysis 48h. Admit. Possible transfer.
Scenario 2: 30 weeks, fFN positive but cervix 25 mm, QUiPP 3%
Low overall risk. Safety-net + home. Repeat assessment if symptoms continue.
Scenario 3: Previous 30-wk delivery, this pregnancy 26 wk, cervix 20 mm
High-risk surveillance. QUiPP guides cervical length + fFN frequency. Progesterone in place.
Scenario 4: 32 weeks, twins, contractions, QUiPP 25%
High risk. Steroids. Admit. Tocolysis. NICU prep for twins.
Scenario 5: 34 weeks, mild contractions, QUiPP 1%
Very low risk. Safety-net + home. No steroids needed.
Care guidance — QUiPP
- Used in symptomatic + high-risk asymptomatic women.
- Combines fFN + cervical length + history.
- Guides admission, steroids, magnesium, transfer.
- NICE-supported.
- Better than individual tests alone.
- Shared decision-making with team.
- Available free for clinicians on app stores.
Sources
- NICE NG25. Preterm labour and birth.
- Watson HA, et al. EQUIPTT trial: QUiPP app vs standard care for preterm birth prediction. PLoS Med 2020.
- QUiPP App. quipp.org.
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Frequently asked questions
What is the QUiPP app?
FREE clinical app that calculates PRETERM BIRTH RISK using QUANTITATIVE fetal fibronectin (qfFN) + CERVICAL LENGTH + maternal history. Developed by Andrew Shennan / King's College London team. NICE-supported decision aid. PROVIDES individualised % risk of delivery within 14 days, 30 days, before 30/34/37 weeks. INFORMS clinical decisions: admit, give steroids, transfer mother to specialist centre, reassure + discharge. USED in UK NHS, US, and globally for women with threatened preterm labour or high-risk asymptomatic.
Who uses QUiPP?
OBSTETRICIANS + MIDWIVES in: (1) Emergency/labour ward — symptomatic women with contractions; (2) Antenatal clinic — surveillance of high-risk women (previous preterm, short cervix). PROVIDES quantitative risk for clinical conversation. NOT a patient-facing app — clinical decision support. RESULTS shared with women in shared decision-making.
What goes into the calculation?
(1) QUANTITATIVE fFN (qfFN) — exact value in ng/mL, not just pos/neg; (2) CERVICAL LENGTH on TVUS in mm; (3) GESTATIONAL AGE at testing; (4) PARITY (previous births); (5) PREVIOUS preterm birth history; (6) SYMPTOMS (contractions, etc.); (7) MULTIPLE pregnancy status. CALCULATES probability of delivery in various windows. SIMPLE interface — clinician inputs values, gets risk estimate.
What's it useful for?
DECISION SUPPORT: (1) ADMIT vs DISCHARGE — high risk → admit + treatment; low risk → safety-net + home; (2) ANTENATAL STEROIDS — high risk + 24-34 wk → give; (3) MAGNESIUM SULPHATE — high risk + <32 wk → neuroprotection; (4) IN-UTERO TRANSFER to specialist NICU if delivery imminent + early gestation; (5) TOCOLYSIS — try to delay 48h for steroids; (6) ROUTINE SURVEILLANCE — schedule repeat tests / scans; (7) PARENT COUNSELLING — clear % risk facilitates informed discussion.
How accurate is QUiPP?
GOOD — validated in multiple UK + international studies. EQUIPTT trial (2020): QUiPP-guided care reduced unnecessary admissions + interventions vs standard care. NEGATIVE PREDICTIVE VALUE high — low-risk women can be safely discharged. POSITIVE PREDICTIVE VALUE moderate — most positive screens don't deliver in 14 days, but identifies women warranting treatment. BETTER than individual tests alone (fFN OR cervical length only).
Can I see QUiPP at home?
APP exists but designed for CLINICIANS — needs clinical inputs (qfFN result, cervical length). DOWNLOAD: free on iOS / Android (named QUiPP). YOU can review with your team — clinician inputs your real numbers. EDUCATIONAL value for understanding your own risk. NOT for patient self-management alone.
What's a 'high risk' QUiPP result?
VARIES by app version but typically: ≥5% risk of delivery in 14 days = significant. >10-20% = high; immediate action. <5% = low risk; safety-netting + discharge often appropriate. THRESHOLDS used for decisions about steroids, magnesium, transfer. SHARED DECISION-MAKING with you and team.
What if my QUiPP risk is low?
REASSURING. SAFETY-NET advice (warning signs to return); HOME if otherwise well; FOLLOW-UP scan / fFN in days-weeks if needed. <1% chance of delivery within 14 days with very low QUiPP. CAN AVOID hospital admission, antenatal steroids, family disruption. STILL CALL if: contractions worsen; bleeding; reduced movements; waters break; severe pain. RETURN if condition changes.
What if it's high?
ADMIT TO HOSPITAL; STEROIDS if 24-34 wk; MAGNESIUM SULPHATE if <32 wk + delivery imminent; TOCOLYSIS to delay labour 24-48h for steroid effect; IN-UTERO TRANSFER to specialist neonatal unit if early gestation; NEONATAL TEAM PREPARED. INTENSIVE monitoring (CTG, scans). COUNSELLING about preterm care + outcomes.
Is QUiPP only for women with contractions?
USED for BOTH: (1) SYMPTOMATIC (contractions, possible labour) — most common use; (2) ASYMPTOMATIC high-risk surveillance (previous preterm, short cervix found incidentally, twin pregnancy) — selected use. EXPANDS over time as evidence grows. PROTOCOLS vary by unit.
How does QUiPP fit with cervical length and fFN?
QUiPP COMBINES both into single risk number. INDIVIDUAL tests less informative than QUiPP. (1) FFN alone: good NPV; modest PPV. (2) CERVICAL LENGTH alone: similar. (3) QUiPP (both + history): superior at decision-making. SOME UNITS still use individual tests; QUiPP increasingly preferred.
Are there alternatives to QUiPP?
(1) PARTOSURE (PAMG-1 immunoassay) — alternative biomarker; high NPV. (2) ACTIM PARTUS (phosphorylated IGFBP-1) — similar. (3) CERVICAL LENGTH alone. (4) FFN ALONE. (5) CLINICAL ASSESSMENT only (less reliable). QUiPP advantages: free, NICE-supported, multimodal.
Do I need to be in hospital for QUiPP?
TESTS (fFN swab + cervical length scan) require clinical setting. RESULT CALCULATION quick. SOME women: tests done as outpatient; results inform whether admission needed. WHEN PRESENTING with possible preterm labour: hospital usually best for assessment + monitoring.
Will QUiPP results be in my notes?
YES — recorded in maternity notes. INFORMS subsequent care + decisions in next pregnancy if applicable. SHARE with your community midwife / GP for ongoing care. PERSONAL ELECTRONIC RECORDS (BadgerNet) increasingly include.
How does this relate to other calculators on BumpBites?
Companion: /calculators/fetal-fibronectin for fFN detail; /calculators/cervical-length for measurement; /calculators/antenatal-steroids; /calculators/magnesium-sulphate; /calculators/vaginal-progesterone-ptb; /calculators/contraction-timer.