Exploring fetal fibronectin testing as a predictor of labour onset: In parturient women from isolated communities.

Objective: To investigate whether the fetal fibronectin assay would be useful for determining if a woman was close to a term delivery. If effective, this test would allow parturient women to stay in their communities longer.

Design: This feasibility study used a prospective cohort design to examine the negative predictive value of the fetal fibronectin test at term.

Setting: Iqaluit, NU.

Participants: A total of 30 parturient women from rural and isolated communities in Nunavut.

Intervention: Starting at 36 weeks' gestation, women were tested every 2 days, and after 39 weeks this increased to every day until labour.

Main Outcome Measures: The negative predictive value of the fetal fibronectin test was assessed.

Results: Women were no more likely to give birth at 7 or more days after their last negative fetal fibronectin test result relative to their likelihood of giving birth at 6 or fewer days after their last negative test result. Hence, the presence of fetal fibronectin in cervical secretion did not predict term delivery.

Conclusion: This project indicated that the fetal fibronectin test did not have adequate sensitivity or specificity as a diagnostic measure to predict a delay of labour at term.