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.

Study Design: 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.

Conclusion: 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.