2004, Number 6
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ABSTRACTObjective: We evaluated fetal fibronectin levels for the diagnosis of preterm labor. Material and methods: We included 74 randomized patients who were admitted with the diagnosis of preterm labor. Cervical and vaginal fluid samples were washed in buffer solution prior to the introduction of a reactive strip. Results were interpreted after 10 sec. Patients with negative tests were admitted and followed up. Patients who tested positive were treated according to the protocols of each hospital. Finally, the specificity, sensitivity, predictive value, and odds ratio were determined. Results: Results showed specificity, 90%; sensitivity, 70%; positive predictive value, 64%; negative predictive value, 78%; and odds ratio, 22; 50% were first pregnancies with gestational ages between 22 and 34 weeks. Conclusions: We consider that a positive fibronectin test is a useful, low-cost, and reliable tool for diagnosing preterm labor.
Velasco MV. Prevención y tratamiento del parto pretérmino: lo nuevo acerca del viejo problema. Rev Med IMSS 2001;39(5):417-427.
Mancilla RJ. Ruptura prematura de membranas y parto pretérmino. Gac Med Mex 1998;134(4):423-424.
Faron G, Boulvain M. Prediction of preterm delivery by fetal fibronectin: meta-analysis. Obstet Gynecol l998;92(1):153-158.
Goldenberg RL, Iams JD. The preterm prediction study: the value of new vs. standard risk factors in predicting early and all spontaneous preterm births. Am J Public Health 1998;88(2):223-238.
Garite TJ. Case examples for fetal fibronectin in symptomatic patients and asymptomatic high risk patients. Departament of Gynecology and Obstetrics, University of California-Irvine Medical Center, Irvine, CA.
Lockwood CJ. Recent advances in elucidating the pathogenesis of preterm delivery: the detection of patients at risk, and preventative therapies. Curr Opin Obstet Gynecol 1994;6:7-18.
Peaceman AM, Andrews WW, Thorp JM, Cliver SP, Lukes A, Iams JD, et al. Fetal fibronectin as a predictor of preterm birth in patient with symptoms: multicenter trial. Am J Obstet Gynecol 1997; 177:13-18.
Jakson GM, Edwin SS, Varner MV, Casal D, Mitchell MD. Regulation of fetal fibronectin production in human amnion cells. J Soc Gynecol Invest 1996;3:85-88.
Eriksen NL, Parisini VM, Daouts S, Flamm B, Garite TJ, Cox SM. Fetal fibronectin: a method for detecting the presence of amniotic fluid. Obstet Gynecol 1992;80:451-454.
Morrison JC, Albert JR, Mc Laughling BN, Whithworth NS, Roberts WB, Martin RW. Oncofetal fibronectin in patients with false labor as a predictor of preterm delivery. Am J Obstet Gynecol 1993;168:538-542.
Ascarelli MH, Morrison JC. Use of fetal fibronectin in clinical practice. Obstet Gynecol Surv 1997;52:S1-S12.
Benattar C, Taieb J, Fernandez H, Lindendaum A, Frydman R, Ville Y. Rapid fetal fibronectin swab-test in preterm labor patients treated with betamimetics. Eur J Obstet Gynecol Reprod Biol 1997;72:131-135.
Lukes AS, Thorp JM Jr, Eucker B, Pahel-Short L. Predictors of positivity for fetal fibronectin in patients with symptoms of preterm labor. Am J Obstet Gynecol 1997;104:697-701.
Faron G, Boulvain M, Lescrainer JP, Vokaer A. A single cervical fetal fibronectin screening test in population at low risk for preterm delivery: an improvement in clinical indicators. Br J Obstet Gynecol 1997;104:697-701.
Bisits A, Madsen G, McLean M, O’Callaghan S, Smith R, Giles W. Corticotropin-releasing hormone: a biochemical predictor of preterm delivery in a pilot randomized trial of treatment of preterm labor. Am J Obstet Gynecol 1998;178:862-866.
Chien PF, Khan KS, Ogston S, Owen P. The diagnostic accuracy of cervicovaginal fetal fibronectin in predicting preterm delivery: an overview. Br J Obstet Gynecol 1997;104:436-444.
Lopez R, Francis J, Garite T, Dubyak J. Fetal fibronectin detection as a predictor of preterm birth in actual clinical practice. Am J Obstet Gynecol 2000;182:123-130.
King JF, Grant A, Keirse MJ, Chalmers I. Betamimetics in preterm labour: an overview of randomized clinical trials. Br J Obstet Gynecol 1988;95:211-222.
Bartnicki J, Casal D, Kreaden US, Salin E, Vetter K. Fetal fibronectin in vaginal specimens predicts preterm delivery and very low birth weight infants. Am J Obstet Gynecol 1996;174:97197.
Iams JD, Casal D, McGregor JA, Goodwin TM, Kreaden US, Lowensohn R, et al. Fetal fibronectin improves the accuracy of diagnosis of preterm labor. Am J Obstet Gynecol 1995;173:141-145.
Burus D, Ernest JM, Veille JC. Fetal fibronectin, interleukin 6, and C reactive protein are useful in establishing prognostic subcategories of idiopathic preterm labor. Am J Obstet Gynecol 1995;173:1258-1262.