Document Detail

Effectiveness of fetal fibronectin testing compared with digital cervical assessment of women with preterm contractions.
MedLine Citation:
PMID:  17566945     Owner:  NLM     Status:  MEDLINE    
The purpose of this study is to determine the effectiveness of fetal fibronectin (FFN) compared to assessment of cervical dilation (CD) in clinical management of women with symptomatic preterm labor (PTL). Pregnant women presenting to Thomas Jefferson University Hospital between May 1, 2001 and November 30, 2002 with symptomatic PTL underwent FFN sampling and had a complete clinical evaluation including a pelvic bimanual examination. Inclusion criteria were singleton pregnancy, gestational age (GA) between 24 (0) and 33 (6) weeks, CD < 3 cm, and intact amniotic membranes. FFN samples were sent out and results were available within 4-12 hours. Clinical management including tocolysis, antenatal steroids, and hospitalization was determined based on digital CD assessment and FFN status. A dilated cervix was defined as CD > 1 cm. Ninety-three patients were included. Spontaneous preterm delivery (SPTD) at < 37 weeks occurred in 20 of 93 (21.5%) patients. Medical therapy use was significantly higher in patients with dilated cervix than in those with a closed cervix (all P values < 0.05). Tocolysis and steroid use in FFN-negative patients and FFN-positive patients were not significantly different. Furthermore, tocolytic use was higher in FFN-negative patients than in women with positive FFN (50% versus 42.1%; P = 0.53). Use of antenatal steroids was similar in patients with CD >/= 1 cm and a positive FFN (54.5% versus 47.4%; P = 0.92). Compared with FFN-negative patients, women with closed cervix were less likely to undergo interventions. In symptomatic PTL patients, CD determined clinical management more than FFN status. Overall, the use of FFN was not effective in decreasing "unnecessary" clinical interventions.
Julio Mateus; Leonardo Pereira; Jason Baxter; Vincenzo Berghella; Jorge Tolosa
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2007-06-13
Journal Detail:
Title:  American journal of perinatology     Volume:  24     ISSN:  0735-1631     ISO Abbreviation:  Am J Perinatol     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-06-28     Completed Date:  2007-08-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8405212     Medline TA:  Am J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  381-5     Citation Subset:  IM    
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
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MeSH Terms
Cervix Uteri* / physiopathology
Fetus / chemistry*
Fibronectins / analysis*
Obstetric Labor, Premature / diagnosis*,  epidemiology,  physiopathology,  prevention & control
Physical Examination*
Predictive Value of Tests
Risk Factors
Reg. No./Substance:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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