Test that predicts premature labour: efficacy of foetal fibronectin test and its cost implications

Introduction Many women come to labour ward with threatened premature labour but only 50% actually deliver. The foetal fibronectin can be used to identify women who will not deliver within 14 days. Its use has been predicted to reduce hospital admission, use of tocolytic and in-utero transfer. Objectives To assess the efficacy of foetal fibronectin test and to analyse the cost implication of using foetal fibronectin test. Design Retrospective case notes review and telephone survey for 3 months periods. Total number of patient contacted was 30. Results 26 women had a negative fibronectin and only 1 delivered prematurely .8 were admitted for management of pain and only 6 were given steroids. There were 4 women with positive fibronectin and 2 delivered prematurely. Steroids were given to 3 women, however none were given tocolysis and none had in-utero transfer Conclusion The foetal fibronectin test accurately predicted women who were NOT likely to deliver prematurely and the use of foetal fibronectin test has led to 50% decrease in cost of tocolytics over a 3month period Recommendation It is our recommendation that the use of fibronectin continues and perhaps consideration be given to out current protocol that tocolysis be given only to women with positive fibronectin result.