The accuracy of cervicovaginal fetal fibronectin as a predictor of preterm birth was studied in patients with increased risk for preterm delivery (according to the Creasy-score). In a prospective blind observational study the smear from the posterior fornix vaginae of 56 pregnant patients without PROM was examined using a quantitative immunoassay for the detection of fetal fibronectin. The patients who tested positively for fetal fibronectin had significantly more preterm deliveries than those with a negative result (CHI square-test, p < 0.01, RR 5.1). Overall, sensitivity, specificity, positive and negative predictive values were 56%, 87%, 45% and 91%, respectively. In patients with preterm labor these values were 75%, 87%, 60%, and 93%, respectively. No patient with a negative result delivered preterm during the following two weeks. It is concluded that performing the fetal fibronectin test in patients with preterm labor is useful for the prediction of preterm birth. Routine testing in patients at increased risk (asymptomatic patients) is not recommended for lack of effectiveness.

译文

宫颈阴道胎儿纤连蛋白作为早产预测指标的准确性已在早产风险增加的患者中进行了研究(根据Creasy评分)。在一项前瞻性盲观察研究中,使用定量免疫测定法检测了56例无PROM的孕妇的后穹vagina阴道涂片,以检测胎儿的纤连蛋白。胎儿纤连蛋白检测阳性的患者早产的结果明显高于阴性结果(CHI Square-test,p <0.01,RR 5.1)。总体而言,敏感性,特异性,阳性和阴性预测值分别为56%,87%,45%和91%。在有早产的患者中,这些值分别为75%,87%,60%和93%。在接下来的两周内,没有阴性结果的患者早产。结论是在早产患者中进行胎儿纤连蛋白测试有助于预测早产。不建议对风险较高的患者(无症状的患者)进行常规检查,因为其缺乏有效性。

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