TITLE:
The Combination of the Fetal Fibronectin Bedside Test and Cervical Length in Preterm Labor Is Useful for Prediction of Preterm Birth
AUTHORS:
Monya Todesco, Moritz Hartog, Thomas Fabbro, Olav Lapaire, Irene M. Hoesli
KEYWORDS:
Preterm Labor, Fetal Fibronectin, Cervical Length, Preterm Birth
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.5 No.13,
November
11,
2015
ABSTRACT: Objective: To determine the
value of fetal fibronectin (FFN), cervical length (CL) measurement and their
combination as binary predictors for preterm birth (PB) in women with preterm
labour (PTL) between 24 + 0 and 34 + 0 weeks. Methods: One hundred fifty-nine
patients with signs of PTL (singleton pregnancies (SP) = 125, twin pregnancies
(TP) = 34) were evaluated in a retrospective study. Inclusion criteria were contractions
> 4/20 min, intact membranes, no bleeding. The cut-off was ≥50 ng/ml for FFN
and ≤20 mm for CL measured by transvaginal ultrasound. The primary outcome
variable was delivery within 7 days from admission. Results: We evaluated 125
SPs and 34 TPs. In SPs, both methods had a sensitivity of 80%; the specificity
was 82% for FFN, and 50% for CL. For the combination of both tests sensitivity
was 80% and specificity 88%. In TPs, the sensitivity of both tests was lower
(FFN 33%, CL 67%) but the combination of both tests represented the highest
result for specificity (77% compared to 68% for FFN alone and 32% for CL
alone). Conclusion: The combination of FFN and CL in PTL results in a
significant higher specificity in SPs. In TPs the performance of the tests is
less accurate.