Page last updated at 00:02 GMT, Tuesday, 8 December 2009

Simple test 'can spot premature birth false alarms'

Baby in incubator
Facilities for treating premature babies are often in high demand

A simple test can help reliably determine whether signs of an imminent premature delivery are likely to result in a false alarm, research suggests.

Less than half of women showing these signs actually go on to give birth soon after, and they often have to undergo what turn out to be unnecessary tests.

UK researchers found a test that looks for a protein called fetal fibronectin (fFN) could solve the problem.

The study was conducted by University College London.

Women with a negative test can be reassured that they do not need inpatient care
Dr Anna David
University College London

Details were presented to a Royal College of Obstetricians and Gynaecologists conference.

fFN is the protein that helps attach the foetal sac, in which the foetus develops, to the uterus.

Previous research has shown that when fFN is found to be leaking at a certain stage of pregnancy, a premature birth is more likely.

A test to detect fFN levels is relatively cheap and easy to perform - but it is not commonly used in all maternity units.

It is done at the same time as a vaginal examination, which is routinely carried out when a woman is admitted with abdominal pain in pregnancy.

If the results show low levels of fFN, then the chance of a women having a premature delivery imminently is low.

Drug intervention

The researchers conducted an audit to determine whether use of the test made any significant difference.

Initially they analysed 22 cases of women admitted to hospital showing signs of being about to go into premature labour.

Of these, 17 did not give birth during their hospital stay, which averaged just more than eight days.

Most received steroid drugs to improve their baby's lung function, or tocolytic drugs to halt labour contractions.

The situation changed significantly after staff began to use the fFN test.

It proved to be 98.6% accurate in identifying women who, despite showing signs of premature delivery, did not go into labour for at least another two weeks.

As a result just seven women out of 78 who showed signs of being about to go into labour, but who registered low levels of fFN, required hospital treatment - for pain management.

Lead researcher Dr Anna David said: "Threatened pre-term labour often causes much anxiety for pregnant women.

"Doctors are working hard to uncover the causes of pre-term birth and to develop preventive treatments.

"In the meantime, the fetal fibronectin test has been found to be very accurate at predicting those women who will not imminently deliver.

"Women with a negative test can be reassured that they do not need inpatient care.

"They can therefore avoid leaving their families for observation in a hospital, though a few may need admission for pain relief.

"More importantly, unnecessary drug interventions can be prevented, which could translate into significant cost savings to the NHS."

Dr David said the study also suggested that use of the fFN test could reduce unnecessary transfer of pregnant women to hard-pressed specialist neonatal units.

Ms Maggie Blott, an obstetrician at King's College Hospital, in London, agreed that widespread use of the test could ensure that women were not given drugs or moved to specialist centres unnecessarily.

She said: "A lot of women present with possible pre-term labour, but only time will tell for certain whether they will actually give birth early.

"This test is easy to use and can give results quickly."



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