Cost-effective standardization of preterm labor evaluation.
OBJECTIVE
The purpose of this study was to determine the effect of a standardized evidence-based protocol for preterm labor evaluation on resource use and obstetrics outcomes.


METHODS
We conducted a retrospective 12-month observational study of patients with symptoms of preterm labor at the Mayo Clinic. All patients underwent triage evaluation per a standardized protocol with a combination of cervical length measurement with contingent fetal fibronectin assay.


RESULTS
Of 201 patients who underwent evaluation, 3 women delivered within 7 days, and only 1 woman delivered after a negative evaluation. Mean gestational age at evaluation was 29 weeks 1 day, and delivery was at 38 weeks 3 days of gestation, with an average interval of 57.4 days until delivery. The rate of hospital admission was reduced by 56%, compared with the previous year; an estimated annual cost saving was $39,900.


CONCLUSIONS
Implementation of a standardized protocol for evaluation of preterm labor reduces the rate of unnecessary hospital admissions for observation with consequent significant reduction in expenses.
Rose
Carl H
CH
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN, USA.
McWeeney
Dennis T
DT
Brost
Brian C
BC
Davies
Norman P
NP
Watson
William J
WJ
D054791:Cervical Length Measurement; D002584:Cervix Uteri / Q000000981:diagnostic imaging; D002985:Clinical Protocols; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D005260:Female; D005353:Fibronectins / Q000032:analysis*; D006801:Humans; D007752:Obstetric Labor, Premature / Q000175:diagnosis*; D010343:Patient Admission / Q000191:economics* / Q000706:statistics & numerical data; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis; D047928:Premature Birth / Q000453:epidemiology / Q000517:prevention & control; D012189:Retrospective Studies; D014218:Triage
D005353:Fibronectins