Document Detail


Fetal fibronectin testing in patients with short cervix in the midtrimester: can it identify optimal candidates for ultrasound-indicated cerclage?
MedLine Citation:
PMID:  19070833     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The objective of the study was to determine the relationship between fetal fibronectin (fFN) testing prior to ultrasound-indicated cerclage and obstetric outcome. STUDY DESIGN: Singleton pregnancies between 18 and 24 weeks' gestation with an ultrasound-diagnosed short cervix (< 25 mm) and funneling (> 25%) of the chorioamniotic membranes into the endocervical canal were analyzed. The fFN testing was performed and patients were randomized to cerclage or no-cerclage. Groups were stratified by fFN result. Cerclage patients were compared with no-cerclage patients. The primary outcome was delivery prior to 35 weeks' gestation. RESULTS: Spontaneous preterm birth prior to 35 weeks' gestation occurred in 15 (44.1%) fFN-positive-cerclage patients and 16 (55.2%) fFN-positive no-cerclage patients (P = .45). Similarly, it occurred in 16 (17.8%) fFN-negative cerclage patients and 11 (17%) fFN-no-cerclage patients (P = .99). CONCLUSION: fFN did not identify optimal candidates for cerclage. However, fFN testing before an ultrasound-indicated cerclage aids in counseling patients, anticipating the outcome of pregnancies complicated by cervical shortening.
Authors:
Sean M Keeler; Ashley S Roman; Jaclyn M Coletta; Daniel G Kiefer; Martin Feuerman; Orion A Rust
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2008-12-13
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  200     ISSN:  1097-6868     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-02-02     Completed Date:  2009-02-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  158.e1-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynecology, New York University Medical Center, New York, NY, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Cerclage, Cervical*
Cervix Uteri / secretion
Female
Fetus
Fibronectins / analysis*
Humans
Pregnancy
Pregnancy Complications / surgery*,  ultrasonography
Pregnancy Outcome
Pregnancy Trimester, Second
Premature Birth / etiology,  prevention & control*
Uterine Cervical Diseases / complications,  surgery*,  ultrasonography
Vagina / secretion
Chemical
Reg. No./Substance:
0/Fibronectins

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


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