19 January 2016
A new mobile app has been developed that offers the potential to help increase the safety of fertility procedures and minimise the risk of preterm births.
Developed by King's College London, the new QUiPP app is designed to aid doctors in more easily identifying women who are at risk of giving birth prematurely, allowing them to receive tailored care.
The app is available to download for free for iOS devices and uses an algorithm to combine the gestation of previous pregnancies and the length of the cervix with levels of foetal fibronectin to classify a woman's risk. It can be used to improve the estimation of the probability of delivery before 34 weeks of gestation, or within two weeks of the foetal fibronectin test, and to therefore potentially inform clinical management decisions.
Foetal fibronectin is a biomarker found in vaginal fluid, with tests usually conducted from 23 weeks into pregnancy. One of the key innovations of this new testing method is that it can be accurately used during the first half of pregnancy.
To test the effectiveness of the software, a team from King's College London conducted a pair of studies to evaluate its performance, results from which have been published in the journal Ultrasound in Obstetrics & Gynecology.
In the first, data was collated from 1,249 women at high risk for premature birth attending preterm surveillance clinics, who were deemed to be at risk because of a previous early pregnancy despite not showing any symptoms. The second, meanwhile, looked at 382 women who were showing symptoms of early labour, which often does not progress to real labour.
In both studies, the app was found to perform well as a predictive tool and offer significant advantages compared to assessing each component - previous pregnancies, cervical length or foetal fibronectin levels - taken alone.
It was noted that further work is needed to clinically evaluate the model in practice and to ascertain whether subsequent interventions can actually improve pregnancy outcomes among women identified as being at high risk by the app. Nevertheless, the results indicated so far present potential cause for optimism.
Lead author Professor Andrew Shennan, professor of obstetrics at King's College London, said: "Doctors need reliable ways of predicting whether a woman is at risk of giving birth early. It can be difficult to accurately assess a woman's risk, given that many women who show symptoms of preterm labour do not go on to deliver early.
"The more accurately we can predict her risk, the better we can manage a woman's pregnancy to ensure the safest possible birth for her and her baby, only intervening when necessary to admit these higher-risk women to hospital, prescribe steroids or offer other treatments to try to prevent an early birth."
Worldwide, it is estimated that around 15 million babies are born preterm each year, with more than one million of these dying of prematurity-related complications. It is hoped that this app could help to address this statistic.
Posted by Edward Bartel
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