Originally Posted by miriam
Did your insurance cover the cost of the test? Sometimes that is a litmus test as to the real necessity of the test.
My insurance will cover the test between 24 and 34 weeks (22 to 34 in a multiple pregnancy) for women presenting with signs of preterm labor. Their policy is to pay for the test every two weeks during that time.
I really think that we have to distinguish between the original purpose of the test, and the blatant misuse of the test. I think that use of the test at term is absurd, and certainly the test isn't perfect. It won't predict PROM, and it certainly isn't some kind of fortune-telling device. A positive result is unreliable, and even a negative result is only 99% reliable-- that other 1% represents real mamas and babies, not just numbers. But that doesn't make the test all bad.
Some women having regular contractions and cervical change during that time period are truly in preterm labor, and delaying labor to administer steroids is lifesaving for those babies. Other women just contract a lot, or experience early effacement and dilation, and it's perfectly normal for them, and they go on to carry to term with no treatment at all. The FFN test was intended to sort that out, so as to avoid unnecessary interventions in normal pregnancies.
I would challenge anyone who would tell me that a woman having regular contractions and cervical change at 29 weeks (for example) would be wrong to consent to this test. What would you do in that situation? Tocolytic drugs have terrible side effects and restriction of activity is very hard on a woman's body, but a 29-week preemie and months of life in the NICU are nothing to mess around with either. Preterm contractions have been notoriously over-treated, and the FFN (as well as measurement of cervical length by ultrasound in symptomatic women, another very reliable indicator) offers a way to make evidence-based decisions about how to handle those situations, so that we're no longer just pumping any mama who's contracting full of terbutaline whether or not she really needs it.
It's easy to talk about interventions being unnecessary if you are among the great majority who have uneventful, normal pregnancies. Not all of us do.
But I will still agree that use of the test at term is ridiculous.