Failure of cervical fibronectin to predict premature delivery in a population of monofetal pregnancies with idiopathic preterm labor.
OBJECTIVE
The purpose of the study was to evaluate the correlation between the presence of cervical fibronectin in a high-risk population of women with symptoms of preterm labor and the occurrence of preterm delivery or the need for aggressive tocolysis.


METHODS
One hundred and thirty women presenting with symptoms of threatened preterm labor were included. Cervical sampling for detection of fibronectin was performed on admission and every day until discharge or delivery. Time to delivery, length of hospital stay, use of indomethacin, delivery before 37 weeks of GA, mean term of delivery and failure of tocolysis to prevent delivery were compared to fibronectin test results. Data were analyzed using Student's t-test for continuous variables and the chi(2) test or Fisher exact test for discrete variables.


RESULTS
No correlation could be found between the results of fibronectin cervical sampling on admission and any of the outcome parameters studied. Test performances were low (sensitivity 28%, specificity 57%, positive predictive value 19%, negative predictive value 69%). Results were not modified when the findings of repeated tests were taken into account.


CONCLUSIONS
Cervical fibronectin failed to discriminate a subgroup of symptomatic women delivering prematurely. The prognostic value of fibronectin testing was not better than clinical data in our series. This observation is in disagreement with previous studies on the diagnostic value of vaginal or cervical fibronectin in preterm labor.
Voluménie
J L
JL
Department of Obstetrics and Gynecology, Hôpital Universitaire Robert Debré, 48 boulevard Sérurier, 75019 Paris, France.
Guibourdenche
J
J
Doridot
V
V
Sibony
O
O
Oury
J F
JF
Blot
P
P
Luton
D
D
D002584:Cervix Uteri / Q000737:chemistry*; D036861:Delivery, Obstetric; D005260:Female; D005353:Fibronectins / Q000032:analysis*; D005865:Gestational Age; D006801:Humans; D007902:Length of Stay; D008137:Longitudinal Studies; D007752:Obstetric Labor, Premature / Q000175:diagnosis*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013997:Time Factors; D015145:Tocolysis
D005353:Fibronectins