EP17.31: Evaluation of the QUiPP app on the management of threatened preterm labour before 34 weeks of gestation: report of a single hospital study

To evaluate the usefulness of the QUiPP App in triaging women at risk of spontaneous preterm birth (sPTB) before 34 weeks' gestation. The date of pregnant women between 23+0 and 33+6 weeks' gestation with symptoms of threatened preterm labour (TPTL) from October 2018 and October 2021 were retrieved from the database of our hospital. Each case of TPTL was retrospectively reviewed a risk for sPTB within 14 days, using the QUiPP App. As cervicovaginal fluid quantitative fetal fibronectin (qfFN) test is not available in routine examinations in Japan, we incorporated risk factors and transvaginal ultrasound assessment of cervical length (CL). A primary outcome of delivery within 14 days was used to assess the predictive accuracy of the QUiPP App. This study included 40 admitted patients. Using a 5% risk of delivery within 14 days as the threshold, a sensitivity was 83.3% (95% CI,35.9-99.6%) and a specificity was 76.5% (95% CI,58.8-89.3%). The positive predictive value (PPV) was 38.5% (95% CI,13.9-68.4%) for delivery within 14 days and the negative predictive value (NPV) was 96.3% (95% CI,81.0-99.9%). The group with negative test results (<5% risk of delivery within 14 days) had a higher rate of full-term delivery than positive results group, 74.1% vs 38.5%. There is a possibility that the patients with negative results could have avoided unnecessary hospitalization because the number of full-term deliveries increased in negative results group. This group originally might have a low risk of sPTB. Using a 5% risk of delivery within 14 days according to the QUiPP App as the threshold, both sensitivity and NPV were high. This shows that the QUiPP App could be a valuable aid in clinical decision-making in Japan even though qfFN test could not be available.