Cost-effective standardization of preterm labor evaluation

Am J Obstet Gynecol. 2010 Sep;203(3):250.e1-5. doi: 10.1016/j.ajog.2010.06.037.

Abstract

Objective: The purpose of this study was to determine the effect of a standardized evidence-based protocol for preterm labor evaluation on resource use and obstetrics outcomes.

Study design: We conducted a retrospective 12-month observational study of patients with symptoms of preterm labor at the Mayo Clinic. All patients underwent triage evaluation per a standardized protocol with a combination of cervical length measurement with contingent fetal fibronectin assay.

Results: Of 201 patients who underwent evaluation, 3 women delivered within 7 days, and only 1 woman delivered after a negative evaluation. Mean gestational age at evaluation was 29 weeks 1 day, and delivery was at 38 weeks 3 days of gestation, with an average interval of 57.4 days until delivery. The rate of hospital admission was reduced by 56%, compared with the previous year; an estimated annual cost saving was $39,900.

Conclusion: Implementation of a standardized protocol for evaluation of preterm labor reduces the rate of unnecessary hospital admissions for observation with consequent significant reduction in expenses.

MeSH terms

  • Cervical Length Measurement*
  • Cervix Uteri / diagnostic imaging
  • Clinical Protocols*
  • Cost Savings
  • Cost-Benefit Analysis
  • Female
  • Fibronectins / analysis*
  • Humans
  • Obstetric Labor, Premature / diagnosis*
  • Patient Admission / economics*
  • Patient Admission / statistics & numerical data
  • Pregnancy
  • Pregnancy Complications / diagnosis
  • Premature Birth / epidemiology
  • Premature Birth / prevention & control
  • Retrospective Studies
  • Triage*

Substances

  • Fibronectins