Innovation in Practice:

This paper reports on an innovation, within a maternity unit, to introduce a fetal fibronectin, point of care test, that will aid the clinician in correctly diagnosing preterm labour. In turn this will assist in developing an individual plan of care for each woman with suspected preterm labour, rather than treating each case with the same interventions regardless of subsequent outcomes. Fetal fibronectin (fFN) is a complex adhesive glycoprotein which can be detected in the cervicovaginal secretions of women during pregnancy. Its concentration varies throughout pregnancy, detectable before 24 weeks of pregnancy the concentration then dips below the minimum detectable level up to 34 weeks of pregnancy, unless the woman is in preterm labour. The fFN test was successfully introduced into clinical practice. Demonstrating that when used appropriately, on women with symptomatic suspected preterm labour, fFN testing can aid in accurate diagnosis and thereby avoid unnecessary, costly interventions. KEY PHRASES  The majority of women (80%) who present with the signs and symptoms of preterm labour will go on to deliver at, or after, 37 weeks gestation (Morgan et al 2007)  Interventions and treatments for this group of women can therefore be unnecessary and costly.  Fetal Fibronectin (fFN) is a complex adhesive glycoprotein which can be detected in the cervicovaginal secretions during pregnancy.  A negative fFN test is 99.2% predictive that the woman will not deliver in the next 14 days (Honest.et al 2002)  The introduction of a safe, simple fFN test can assist in correctly diagnosing true preterm labour, therefore avoiding unnecessary, costly interventions.