Sonographic measurement of cervical length and fetal fibronectin testing in threatened preterm labor
Date
2006
Authors
Tsoi E.
Akmal S.
Geerts L.
Jeffery B.
Nicolaides K.H.
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Abstract
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. Copyright © 2006 ISUOG. Published by John Wiley & Sons, Ltd.
Description
Keywords
fetoprotein, fibronectin, uterus spasmolytic agent, adolescent, adult, article, body mass, cigarette smoking, clinical trial, controlled clinical trial, controlled study, ethnic group, female, fetus membrane, gestational age, human, imminent abortion, intermethod comparison, logistic regression analysis, major clinical study, maternal age, parity, pregnant woman, premature labor, priority journal, transvaginal echography, uterine cervix cytology, uterine cervix dilatation, uterus contraction, Adult, Biological Markers, Body Mass Index, Cervix Uteri, Continental Population Groups, Female, Fibronectins, Gestational Age, Glycoproteins, Humans, Logistic Models, Maternal Age, Obstetric Labor, Premature, Parity, Pregnancy, Pregnancy Trimester, Third, Recurrence, Regression Analysis, Risk Assessment, ROC Curve, Sensitivity and Specificity, Ultrasonography, Prenatal
Citation
Ultrasound in Obstetrics and Gynecology
27
4
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4