Efficacy of fibronectin and its impact on the use of atosiban – cost implication

Aim Our aim of this audit was to assess the effectiveness of fetal fibronectin test and the cost impact of its introduction. Findings Over the 3month period 39 tests were done. Data was collected on 30 (76%) women. Of the 30 women 10 ( 33%) had previous preterm birth 4 (13%) had positive result 26 (87%) had negative result In the positive group, all 4 (13%) stayed in hospital with a mean duration of hospital say 9.5days. Steroids were given to 3 (75%) but none was given tocolysis (to halt contractions) and none had an inutero transfer to another hospital. Of 4 positive patients, 2 delivered as preterm. Of the 26 women in threatened preterm labour with negative fibronectin result, only 8 (30%) were admitted for the management of abdominal pain. 6 (23%) were given steroid and 3 (11%) given tocolysis to halt contractions. The mean duration of hospital stay was 4 days. None had an inutero transfer. Of the 26 women with negative result, only 1 (0.04%) delivered as preterm. Conclusions Our study findings demonstrate that fetal fibronectin has been shown to be accurate in predicting those women who will not deliver imminently. The treatment cost of tocolysis (atosiban) is on average £500 per patient. In the 3months since the introduction of fetal fibronection, only 3 women (11%) were treated with atosiban.