Selective use of fetal fibronectin detection after cervical length measurement to predict spontaneous preterm delivery in women with preterm labor
| Autor: | Thomas Schmitz, Gilles Kayem, Françoise Maillard, Sandrine Bessard-Bacquaert, François Goffinet, Y. Fulla, Dominique Cabrol |
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| Rok vydání: | 2006 |
| Předmět: |
Adult
medicine.medical_specialty Cervix Uteri Sensitivity and Specificity Fetus Obstetric Labor Premature Predictive Value of Tests Pregnancy medicine Humans Single-Blind Method Prospective Studies Prospective cohort study Ultrasonography Gynecology Fetal fibronectin business.industry Obstetrics Obstetrics and Gynecology medicine.disease Fibronectins Cervical Length Measurement Premature birth Predictive value of tests Premature Birth Gestation Female business |
| Zdroj: | American Journal of Obstetrics and Gynecology. 194:138-143 |
| ISSN: | 0002-9378 |
| DOI: | 10.1016/j.ajog.2005.05.074 |
| Popis: | The purpose of this study was to determine whether selective use of fetal fibronectin detection after ultrasound measurement of cervical length predicts preterm delivery in symptomatic patients better than either indicator alone.This prospective blinded study performed both tests on 359 women hospitalized for preterm labor between 18 and 34 completed weeks' gestation. The primary outcome was preterm delivery before 35 weeks'gestation.Among the 359 women included, 48 (13.4%) delivered before 35 weeks' gestation. The sensitivity, specificity, and positive and negative predictive values of cervical lengthor = 25 mm were 75%, 63%, 24%, and 94%, respectively, and of fetal fibronectinor = 50 ng/mL, 63%, 81%, 33%, and 93%. Fetal fibronectin detection was significantly (P.001) more specific than cervical length measurement. For selective use of fetal fibronectin detection after cervical length measurement, the test was considered positive if cervical length wasor = 15 mm or if cervical length was between 16 and 30 mm with fetal fibronectinor = 50 ng/mL. The predictive values of this test were not significantly different from those of fetal fibronectin detection (67%, 81%, 36%, and 94%). This strategy could have avoided 200 fibronectin tests.Selective use of fetal fibronectin detection after cervical length measurement is more specific than cervical length and as effective as fetal fibronectin assays in the entire population of women in preterm labor for predicting preterm birth. |
| Databáze: | OpenAIRE |
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