[Quantitative determination of fetal fibronectin in cervical smears: a new marker for evaluating the risk of premature labor].
There is a well-known correlation between ascending infection and preterm labour. Nevertheless, up to now an exact method to identify patients which are at high risk for preterm labour does not exist. Fetal fibronectin is an extracellular matrix protein, which is produced by fetal membranes. High concentrations are present in amniotic fluid, but not in cervical secretions in uncomplicated pregnancies (only in 3-4%). If there is an inflammatory mediated damage to fetal membranes (amnion/chorion) or a mechanical disruption caused by preterm contractions, fetal fibronectin should be released into the cervix and vagina. A prospective clinical study measuring quantitatively the content of fFN in cervicovaginal secretions in patients with preterm labour (n = 43), preterm rupture of membranes (n = 15) and 20 controls was undertaken. In 16 patients frequent specimen could be obtained over a period of several weeks. 14 of the 34 patients with preterm labour, which could be observed until delivery, delivered before term (< 37. WOP). In 13 fFN was present in a concentration > 75 ng/ml (sensitivity: 92.4%). 13 patients were negative for fFN and only one of these patients delivered before term (92% chance of term delivery in absence of fFN in cervicovaginal fluids). In 8 patients with beta-adrenergic treatment fFN was present. All patients delivered before term. The 15 patients with PROM had very high concentrations of fFN with a medium concentration of 967.3 ng/ml. 18 of the 20 control patients were negative for fFN (< 75 ng/ml), 2 had a slightly elevated concentration of 84 and 85 ng/ml.(ABSTRACT TRUNCATED AT 250 WORDS)
Hampl
M
M
Frauenklinikum Mannheim, Fakultät für klinische Medizin, Universität Heidelberg.
Friese
K
K
Hofmann
I
I
Melchert
F
F
D002821:Chorioamnionitis / Q000175:diagnosis*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000175:diagnosis; D005353:Fibronectins / Q000032:analysis*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007752:Obstetric Labor, Premature / Q000517:prevention & control*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods*; D011446:Prospective Studies; D012307:Risk Factors; D015145:Tocolysis; D014626:Vaginal Smears
D005353:Fibronectins
Quantitative Bestimmung von fetalem Fibronektin im Zervikovaginalabstrich: ein neuer Marker zur Beurteilung des Frühgeburtsrisikos bei vorzeitiger Wehentätigkeit.