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Fetal fibronectin as a predictor of spontaneous preterm labour in asymptomatic women with a cervical cerclage
Author(s) -
Duhig KE,
Chandiramani M,
Seed PT,
Briley AL,
Kenyon AP,
Shennan AH
Publication year - 2009
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.2009.02137.x
Subject(s) - fetal fibronectin , medicine , asymptomatic , cervical cerclage , obstetrics , predictive value , gestation , preterm delivery , positive predicative value , gynecology , predictive value of tests , pregnancy , retrospective cohort study , cervical insufficiency , cervix , genetics , biology , cancer
Objective To assess the accuracy of fetal fibronectin (fFN) testing for prediction of preterm labour in asymptomatic high‐risk women with a cervical cerclage. Design Retrospective observational study. Setting United Kingdom. Population Nine hundred and ten asymptomatic women at high‐risk of Preterm birth referred to specialist antenatal clinics and undergoing fFN testing between November 1997 and December 2007. Methods Women had fFN tests taken between 23 +0 and 27 +6 weeks’ gestation, on one or more occasions. Main outcome measures Sensitivity, specificity, positive predictive values and negative predictive values of fFN testing for predicting delivery <30 and <37 weeks were compared in those with and without cerclage. Results For delivery <30 weeks’ gestation, the specificity of fFN testing was significantly lower in women with cervical cerclage (77% vs 90%; P ≤ 0.00001). The sensitivity of the test was similar between the groups (78.6 (no‐cerclage) vs 60% (cerclage); P > 0.4). The negative predictive value of the fFN test for delivery <30 weeks was high in both groups (>98%). Conclusions Asymptomatic high‐risk women with cerclage in situ are more likely to have a false positive fFN test. The negative predictive value is similar.