Availability and use of fetal fibronectin testing and transvaginal ultrasound for preterm labor evaluation in the United States

Abstract

Objective

Measure availability and use of fetal fibronectin (fFN) testing and transvaginal ultrasound to measure cervical length (TVCL) for symptomatic preterm labor (PTL) patients. Additionally, assess the presence and impact of PTL triage protocols.

Study design

Cross-sectional online survey among clinicians from 255 unique hospitals regarding prior 12-month practices (pre-COVID-19).

Results

fFN testing was always available in 87% (221) of hospitals, while TVCL was always available in 69% (175) of hospitals. Utilization was lower: fFN specimens were often/always collected in 61% (156) of hospitals and TVCL was often/always performed in 43% (110) of hospitals. fFN testing was significantly more likely than TVCL to be available and used (p < .05). Written PTL protocols were available in 47% (121) of hospitals but not consistently followed.

Conclusion

The most accurate risk assessment approach for imminent spontaneous preterm birth is the implementation of a universal screening program for symptomatic patients, including fFN testing and TVCL.

Keywords:

• Fetal fibronectin testing (fFN)
• transvaginal ultrasound to measure cervical length (TVCL)
• preterm labor (PTL)
• spontaneous preterm birth (sPTB)
• guidelines

Acknowledgments

The authors would like to acknowledge the valuable contributions of Tiffany M. Bonus, MS for her insights regarding the final analysis and preparation of this manuscript.

Disclosure statement

M.S.R. is a consultant and member of the Hologic speaker’s bureau. No other potential conflict of interest was reported by the authors.

Data availability statement

Due to the nature of this research, participants of this study did not agree for their data to be shared publicly, so supporting data is not available.

Additional information

Funding

M.S.R. and W.M.B. received research funding from Hologic, Inc. to perform this study. Hologic, Inc. did not participate in the data collection, analysis, nor interpretation of the research outcomes.