A test that helps doctors determine whether pregnant women are in premature labour, will no longer be available. The company that makes rapid fetal fibronectin tests will stop selling them from the end of next month. Doctors say pregnant women in rural and remote Australia will be left most at risk.
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00:00The test is basically a way for doctors to determine when a woman presents to a GP or
00:09a hospital with what appear to be contractions, whether that is in fact early labour or whether
00:15it might be instead something like Braxton Hicks contractions or an irritable uterus
00:20or even gastro, which means she wouldn't be in early labour.
00:25So the test is a swab, it's inserted inside the woman and that swab is then placed on
00:30a little cassette, which looks a bit like a COVID test.
00:34That cassette is then put inside a machine and the machine returns a numeric reading.
00:39So if the number that comes back for the medical team is low, it means the woman is not in
00:44early labour.
00:46If the number is high or really high, it means she could have a baby imminently or within
00:51the next week or two.
00:53So the key thing there is the number, the reading that the doctors can get.
00:57So this test is quantitative, not qualitative.
01:01It provides that numeric reading.
01:03So if you're in a rural or remote area, for example, and you are a doctor performing this
01:09test on a woman, she doesn't have any other symptoms, but she does appear to be contracting
01:14and that test then gives you a really high reading, but you've got no other symptoms
01:18to show she's in labour.
01:20That tells you that this woman needs to be evacuated immediately because she could give
01:24birth any day now or any hour even.
01:27So it means doctors, midwives, nurses can then triage that woman in conjunction with
01:33medical or emergency transport services above other patients who might not be as urgent.
01:39And that woman would then be evacuated to a city hospital where there would be a neonatal
01:44intensive care unit, which is crucial for a preemie baby, because while doctors and
01:50teams in rural and regional areas, for example, might have the skills to look after premature
01:55babies, they don't always have the equipment necessary.
01:58And that equipment is so crucial to ensuring better outcomes and even survival for babies
02:04when they're born early.
02:05The company has written to medical communities around the world, it wrote to them back in
02:11July basically saying we've tried everything, we've looked at this, but for various reasons
02:16we need to stop making it.
02:18The only reason that Hologic, the US-based company, actually specified was that there
02:24was variable supply of raw materials which are used to make the device.
02:30So that's the only clear reason we've got.
02:32We have contacted Hologic for comment.
02:35We don't have a response yet.
02:37Doctors or some doctors are sceptical about that reasoning.
02:40They feel that perhaps this is more about economics and that this cost, the cost of
02:46making the product, the device, the rapid foetal fibronectin test just doesn't stack
02:50up and it's just not profitable enough.
02:53Doctors in particularly where I've been looking for this story in rural and regional and remote
02:58areas, if a woman does appear to be in early labour, their priority is at all costs getting
03:04her to a hospital where she and the baby can have the best possible outcome.
03:09What that means is that they will be more likely, without a reliable test, they will
03:16be more likely to err on the side of caution.
03:19And where a test previously may have said, okay, this woman isn't likely to give birth
03:25in the next two weeks, they would be comfortable keeping her at home in her community with
03:30her family.
03:33In future, without that test available, they'd be more likely to go, oh, we're not sure,
03:38so let's not risk it, let's send her to the city hospital to avoid all risk.
03:43That will then put further strain on already stretched emergency transport systems and
03:49services.
03:50So you can imagine that they're dealing with a whole lot of patients already.
03:53This is going to increase their load.
03:54So that's a big concern at the moment.