Does fetal fibronectin testing change patient management in women at risk of preterm labour?
OBJECTIVE
To determine clinicians' indications for, and actions following, fetal fibronectin testing in both symptomatic and asymptomatic women between 23(+0) and 34(+6) weeks' gestation.


METHODS
Following clinician education of the predictive ability of fetal fibronectin testing, results of all fetal fibronectin tests done at St Thomas' Hospital over a 6-week period were analysed. Clinicians were asked if the result changed management and if a reciprocal result would have altered management.


RESULTS
Ninety-seven fetal fibronectin tests were conducted of which 21 (22%) were positive. Follow-up was done for 91 tests of which 25 (28%) test results directly changed management; 81 (89%) test results had the potential to change management independent of the test result.


CONCLUSIONS
The results of fetal fibronectin testing directly influenced management in a significant number of patients. A large number of women were asymptomatic at testing. Fetal fibronectin testing could be offered more widely and has the potential to benefit patient management.
Bolt
Lauren A
LA
Maternal and Fetal Research Unit, King's College London, Division of Reproduction and Endocrinology, St Thomas' Hospital, London SE1 7EH, United Kingdom. lauren.bolt@kcl.ac.uk
Chandiramani
Manju
M
De Greeff
Annemarie
A
Seed
Paul
P
Shennan
Andrew H
AH
D015415:Biomarkers / Q000378:metabolism; D003955:Diagnostic Tests, Routine; D005260:Female; D005333:Fetus / Q000378:metabolism*; D005353:Fibronectins / Q000378:metabolism*; D005500:Follow-Up Studies; D006801:Humans; D007752:Obstetric Labor, Premature / Q000453:epidemiology*; D010346:Patient Care Management / Q000639:trends*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011262:Pregnancy Trimester, Second / Q000378:metabolism; D011263:Pregnancy Trimester, Third / Q000378:metabolism; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity
D015415:Biomarkers; D005353:Fibronectins