TITLE:
Diagnostic Accuracy of PremaQuick versus Actim Partus in Prediction of Preterm Labor in Symptomatic Women within 14 Days
AUTHORS:
Mohannad Abu-Faza, Ibrahim A. Abdelazim, Shikanova Svetlana, Bassam Nusair, Rania H. Farag, Sreelatha R. Nair
KEYWORDS:
PremaQuick, Actim Partus, Preterm Labor
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.8 No.8,
July
27,
2018
ABSTRACT: Background: Preterm labor (PTL) remains a major source of neonatal morbidity, and
mortality. Currently the trans-vaginal cervical length (TVCL), and/or
cervico-vaginal fetal fibronectin (fFN) are the common diagnostic tools used
for prediction of PTL. Consequently, many women and their fetuses are exposed unnecessarily tocolysis and
hospital admission. Objectives: This study was designed to compare the
diagnostic accuracy of PremaQuick versus Actim Partus in prediction of PTL in
symptomatic women within 14 days. Patients and Methods: Two-hundred and
twenty women (220) were included in this comparative prospective study and
classified into two groups: 110
women with threatened preterm labor (TPTL) in the study group, and 110 controls
(no TPTL). Women included in the study were subjected to: through history,
collection of the cervico-vaginal fluid (CVF) samples for assessment by
PremaQuick and Actim Partus tests, followed by trans-vaginal cervical length
(TVCL) assessment. Studied women managed according to the hospitals protocol,
with follow-up
weekly in the obstetrics outpatients’ clinic after discharge from the hospital until delivery. The main outcome
measures the diagnostic accuracy of PremaQuick versus Actim Partus in prediction
of PTL in symptomatic women within 14 days of admission. Results: PremaQuick
test was significantly more specific with higher positive predictive value
(PPV) in prediction of PTL in symptomatic women within 14 days (95.5% and
89.6%; respectively) compared to CL 25 mm
(56.3% and 54.6%; respectively), (P = 0.02 and 0.03; respectively). In
addition, PremaQuick test was significantly more sensitive with higher positive predictive
value (PPV) in prediction of PTL in symptomatic women within 14 days (39.8% and
89.6%; respectively) compared to Actim Partus (13.9% and 55.5%; respectively),
(P = 0.001
and 0.01; respectively). The Odds ratio and the relative risk for prediction of
PTL in symptomatic women within 14 days were significantly high for PremaQuick
compared to the CL 25 mm, and Actim Partus. Conclusion: PremaQuick test seems to be the best complementary test to the CL 25 in prediction of PTL in
symptomatic women within 14 days. PremaQuick test compensates the low
specificity and low PPV of the CL 25 mm
in prediction of PTL.