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The affirm study: assessment of fetal fibronectin testing to improve preterm management
  1. M Chandiramani,
  2. A De Greeff,
  3. J Filmer,
  4. L A Bolt,
  5. E Smout,
  6. A H Shennan
  1. Division of Women's Health, King's College London and King's Health Partners, London, UK

Abstract

Background The use of fetal fibronectin (fFN), an excellent predictor of preterm labour, has reduced resource use without a negative impact on neonatal outcome. We determined resource use before, during implementation and after withdrawal of fFN within a tertiary referral centre.

Methods Resource use was evaluated for a 6 months (Group 1) prior to fFN use. Following introduction of fFN, it was used on symptomatic women presenting to the maternity unit with threatened preterm labour and abdominal pain (23+0–34+6 weeks) for a year (Group 2).It was then withdrawn from service for 6 months (Group 3).

Results Test performance was similar to published studies. In Group 1, 102 women were admitted resulting in a total cost of £649 226 (cost/admission £6365).In Group 2, 253 women were admitted resulting in a total cost of £1 149 808(cost/admission £4545) and in Group 3, 80 women were admitted resulting in a total cost of £621 550 (cost/admission £7769).The length of inpatient stay across groups was similar (2.7 days). Table 1 demonstrates the distribution of resource use.

Abstract PFM.39 Table 1

Distribution of resource use

Conclusion The use of fFN results in a 35% reduction in average cost per admission. Any clinical benefit that may be associated with its use does not incur additional costs.

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