Assessing patients with symptoms of preterm labor
Determining which patients are in preterm labor is a significant challenge. The vast majority of women presenting with symptoms of preterm labor are not in true preterm labor and will go on to give birth at term.1 However, the consequences of missing the opportunity to provide critical interventions in even one patient can be significant.
Standardizing care is critical to improving outcomes
“Protocols and checklists should be recognized as a guide to the management of a clinical situation or process of care that will apply to most patients.”
“Obstetrician-gynecologists should be engaged in the process of developing
guidelines and presenting data to help foster stakeholder buy-in and create
consensus, thus improving adherence to guidelines and protocols.”
“Evidence-based methods of identifying women at risk for premature labor,
including ongoing risk assessment at each visit, screening women with preterm labor contractions using fetal fibronectin (fFN) testing, and screening using cervical length measurement techniques should be accessible in all practice settings.”
“Structured systems may help to optimize communication about and response to rapid changes in patient status. There are a number of elective strategies that can be applied to maternity care:
Communication tools such as Situation-Background-Assessment-Recommendation (SBAR)
Training in principles of crew resource management
Drills and simulations
Debriefings and case reviews
Organized board rounds, huddles, structured handoffs, and bedside rounds
Checklists and standard order sets”
Improve outcomes by implementing a standardized preterm labor triage protocol
Clinical assessment alone is subjective and not predictive
Adding fFN testing increases predictivity of cervical length6
Accurate results are variable even in the hands of skilled and well-trained clinicians when assessing risk of preterm birth by cervical length (CL). Adding fFN testing to cervical length can dramatically improve preterm birth prediction by as much as 50%.
Contact us for more information about the Rapid fFN® test.