title: Rapid fetal fibronectin swab-test in preterm labor patients treated by betamimetics.
abstract: OBJECTIVE
  A preliminary study to examine the value of a rapid fetal fibronectin swab-test used as a bedside test in the prognosis of preterm labor.
  
  
  METHODS
  Women presenting with preterm labor and intact membranes and less than 3 cm dilated were enrolled in a single referral center. Cervicovaginal swabs were assessed for the presence or absence of fetal fibronectin by means of a rapid monoclonal antibody assay the positivity of which was revealed by a colorimetric reaction. Results were compared with uterine contractions frequency, Bishop cervical score, duration of tocolysis and interval to delivery. The predictive value of fetal fibronectin test for delivery within 7, 14 or 21 days from sampling and before 32 and 37 weeks' of gestation was assessed in the two groups.
  
  
  RESULTS
  Among 124 eligible patients, 19 presented with a positive fibronectin test and 105 with a negative one. Gestational age at sampling, Bishop cervical score and duration of tocolysis were identical in the two groups. The number of contractions was significantly lower and gestational age at delivery was significantly higher in the fibronectin negative group. Fetal fibronectin in cervicovaginal secretions has a high sensitivity (89%) for delivery within 7 days. Absence of fetal fibronectin in cervicovaginal secretions of patients presenting with uterine contractions could rule out preterm labor within 7 and 14 days with a predictive value of 99 and 95.2%, respectively. In negative fetal fibronectin patients, preterm delivery before 32 and 37 weeks' is unlikely to occur with a predictive value of 97 and 85%, respectively.
  
  
  CONCLUSIONS
  Cervicovaginal fetal fibronectin detected by a rapid bedside swab-test in women with symptoms of preterm labor compares favourably with quantitative assays and could prove useful in the management of preterm labor. This should be confirmed in a longer prospective study.
authors.affiliation: Department of Biochemistry, Hospital Antoine Beclere, Clamart, France.
authors.forename: C
authors.initials: C
authors.lastname: Benattar
authors.forename: J
authors.initials: J
authors.lastname: Taieb
authors.forename: H
authors.initials: H
authors.lastname: Fernandez
authors.forename: A
authors.initials: A
authors.lastname: Lindendaum
authors.forename: R
authors.initials: R
authors.lastname: Frydman
authors.forename: Y
authors.initials: Y
authors.lastname: Ville
mesh_terms: D000318:Adrenergic beta-Agonists / Q000627:therapeutic use*; D005260:Female; D005333:Fetus / Q000737:chemistry*; D005353:Fibronectins / Q000032:analysis*; D006801:Humans; D007752:Obstetric Labor, Premature / Q000175:diagnosis* / Q000188:drug therapy; D011247:Pregnancy; D012680:Sensitivity and Specificity; D014590:Uterine Contraction
chemical_list: D000318:Adrenergic beta-Agonists; D005353:Fibronectins