Document Detail


Sonographic measurement of cervical length and fetal fibronectin testing in threatened preterm labor.
MedLine Citation:
PMID:  16526097     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: In women presenting with threatened preterm labor, both fetal fibronectin and sonographic measurement of cervical length have been shown to distinguish between true and false labor. The aim of this study was to determine whether the combination of both tests provides a better prediction than the individual tests alone. METHODS: We examined 195 women with singleton pregnancies presenting at 24-36 (median 31) weeks of gestation with regular and painful uterine contractions, intact membranes and cervical dilatation of less than 3 cm. On admission to the hospital fetal fibronectin positivity in cervicovaginal secretions was determined and transvaginal sonographic measurement of cervical length was carried out. The results were not made available to the attending obstetrician. The primary outcome measure was delivery within 7 days of presentation. RESULTS: Delivery within 7 days occurred in 51.4% (18 of 35) of those with cervical length below 15 mm and 0.6% (1 of 160) of those with cervical length of 15 mm or more, in 21.2% (18 of 85) of the fibronectin positive group and in 0.9% (1 of 110) of the fibronectin negative group. There was a significant association between cervical length and the incidence of fibronectin positivity (r = -0.921, P = 0.003). Logistic regression analysis demonstrated that the only significant contributor to the prediction of delivery within 7 days was cervical length, with no significant contribution from fibronectin positivity, ethnic origin, maternal age, gestational age, body mass index, parity, previous history of preterm delivery, cigarette smoking, or use of tocolytics. CONCLUSIONS: In women with threatened preterm labor assessment of fetal fibronectin in cervicovaginal secretions does not improve the prediction of delivery within 7 days provided by the sonographic measurement of cervical length.
Authors:
E Tsoi; S Akmal; L Geerts; B Jeffery; K H Nicolaides
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  27     ISSN:  0960-7692     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2006 Apr 
Date Detail:
Created Date:  2006-04-03     Completed Date:  2006-12-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  368-72     Citation Subset:  IM    
Copyright Information:
Copyright 2006 ISUOG.
Affiliation:
Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK.
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MeSH Terms
Descriptor/Qualifier:
Adult
Biological Markers / blood
Body Mass Index
Cervix Uteri / ultrasonography*
Continental Population Groups
Female
Fibronectins / blood*
Gestational Age
Glycoproteins / blood*
Humans
Logistic Models
Maternal Age
Obstetric Labor, Premature / diagnosis*
Parity
Pregnancy
Pregnancy Trimester, Third
ROC Curve
Recurrence
Regression Analysis
Risk Assessment
Sensitivity and Specificity
Ultrasonography, Prenatal*
Chemical
Reg. No./Substance:
0/Biological Markers; 0/FFN protein, human; 0/Fibronectins; 0/Glycoproteins

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


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