A newborn baby's arrival is never 100 per cent predictable.
Due dates are a doctor's estimate of the time it takes for a full-term infant to develop in the mother's body. Babies, however, don't live by calendars and some arrive significantly early.
For mothers giving birth who live close to the hospital and can get to medical care in time, the life-threatening risks of a pre-term delivery are minimized. But for those who live in rural and remote areas, where access to a delivery room might be hours away, the chances of mom and baby suffering complications while giving birth rise considerably.
Medical technology is finding ways to reduce those risk factors. It's given the women of far-flung northern B.C. communities like Dease Lake, Stewart and Fort Ware a test to predict if they will give birth prematurely. The fetal fibronectin enzyme test developed by Adeza Biomedical Corp. has been found to be one of the most accurate predictors of whether a woman is likely to have a preterm birth within the following two weeks.
"If you're in a place that doesn't have a general practitioner there that week and you have some preterm labour happening, you can go in and get your test done and with a 95 per cent confidence level you're good for the next 14 days and you don't have to travel to Prince George or Smithers for the next few days," said Ken Winnig, Northern Health's director of diagnostic services.
The test involves a vaginal swab sample that is processed using a digital analyzer to detect the presence of the fetal fibronectin protein. Northern Health introduced the test in the northeastern B.C. region in 2007. Other health authorities in the province have seen its value and have since adopted it.
In some areas, 10 per cent of labours are premature and that can cause problems that can endanger the life of the baby. The fibronectin protein binds to the membranes of the uterus and if it is detected, arrangements can be made to transport the expectant mother to the appropriate hospital.
"The test results can be available in 45 minutes and if it's negative it is about 99.9 per cent sure the patient will not be going into labour in the next week," said Prince George obstetrician Brian Galliford.
"If they are premature than their babes can't be looked after properly in a community hospital and some that are very young can't be looked after in Prince George. If every lady came in early with pains and you couldn't tell if she was going to go into labour it would be a very costly thing. It saves a lot on transport costs."
Fewer than 30 per cent of women with positive fibronectin tests go into early labour. It's given to women from 24 weeks of pregnancy onward.
Galliford recalls how the fibronectin test helped one of his patients who was 30 weeks pregnant and already had three kids to look after while her husband was away at work. The test came back negative and she was able to deliver a full-term baby. Had the results been positive, she likely would have had to spend the rest of her pregnancy (10 weeks) hospitalized at B.C. Women's Hospital in Vancouver, which is better-equipped for preemie babies.
"It's been a huge help in managing premature labour," said Galliford. "It's one of the most valuable tests we've had developed in the last few years."
