Comparison of cervical assessment, fetal fibronectin and fetal breathing in the diagnosis of preterm labour.
The management of threatened preterm labour is hampered by an inability to differentiate accurately true from false labour at an early stage. We compared the performance of vaginal assessment, fetal breathing movements and the detection of fetal fibronectin (Ffn) in the prediction of true preterm labour among 25 singleton pregnancies admitted with regular uterine activity, cervical dilatation < 4 cms and intact membranes at 25 to 35 weeks of gestation. A Bishop score of < 2 or a negative Ffn test was highly predictive (100%) of false preterm labour whereas fetal breathing movement detection was less reliable. The positive predictive value of cervical assessment alone was considerably improved with the addition of Ffn testing. The introduction of Ffn testing of cervico-vaginal secretions could result in a more rational use of tocolysis.
Senden
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Department of Obstetrics and Gynaecology, Ninewells Hospital and Medical School, Dundee, Scotland, UK.
Owen
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D000293:Adolescent; D000328:Adult; D005260:Female; D005333:Fetus / Q000502:physiology*; D005353:Fibronectins / Q000032:analysis*; D006801:Humans; D007752:Obstetric Labor, Premature / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011247:Pregnancy; D014621:Vagina / Q000737:chemistry*
D005353:Fibronectins