International Union for Circumpolar Health Ministry of Public Health and Social Development of RF Russian Academy of Medical Sciences Siberian Branch of Russian Academy of Medical Sciences Siberian Branch of Russian Academy of Sciences Medical Polar Fund “Science” The Northern Forum

Abstracts

Child health. Women`s health

Preterm labour occurs in about 20 per cent of pregnancies in the Qikiqtalluq Region of Nunavut. (Muggah et al, 2003) Until recently caregivers in Nunavut had few options when faced with a woman in possible preterm labour one of the health centers in the Territory. Because of the lack of tertiary care for every premature infants and the distance from neonatal facilities, women who presented with possible preterm labour in the Qikiqtalluq Region were air medivaced 160 to 1900 km to Baffin Regional Hospital in Iqaluit and some cases another 2000 km to Ottawa. In addition to being expensive to the system such emergency transfers are extremely disruptive to the lives of the involved women and their families, and put a strain on the resources of the health centers. It was shown for the year 2001 that over 1/3 of these women who were medivaced for apparent preterm labour were not in fact in labour, and delivered their babies at significantly later time. (Muggah et al, 2003) The Fetal Fibronectin Assay Adeza seems to offer the possibility of managing many of these cases safely in a more conservative fashion. The test has been shown to have a negative predictive value of 99.6 for not delivering in less than 7 days in symptomatic women between 24 and 35 weeks estimated gestational age. The test protocol involves a posterior vaginal swab which is processed at the bed side using a small processor. This test was implemented in July 2004 with kits placed at Baffin Regional Hospital and in 4 of the larger health centers in the Region which generated most pf the medivacs in the study year. This paper presents the results of this trail which has shown the test to be safe and reliable, and to have resulted in a significant reduction in medivacs, and significant savings to the health system in Nunavut. More widespread use of the test will begin in 2006.

Note. Abstracts are published in author's edition

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Last update: 06-Jul-2012 (11:52:05)