Pregnancy outcome, intra-amniotic inflammation and the value of repeated fetal fibronectin test in patients with a positive cervical fetal fibronectin.
- Author:
Joon Seok HONG
1
;
Bo Hyun YOON
Author Information
1. Department of Obstetrics and Gynecology, College of Medicine, Seoul National University, Seoul, Korea. Yoonbh@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Fibronectin;
Asymptomatic;
Repeated test;
Amniocentesis;
Preterm labor
- MeSH:
Amniocentesis;
Diagnosis;
Female;
Fibronectins*;
Gestational Age;
Humans;
Inflammation*;
Obstetric Labor, Premature;
Pregnancy;
Pregnancy Outcome*;
Pregnancy*;
Pregnant Women
- From:Korean Journal of Obstetrics and Gynecology
2005;48(3):563-574
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: To determine the useful subsequent study after the positive cervical fibronectin test in asymptomatic woman, fibronectin test was repeated and amniocentesis for the diagnosis of intra-amniotic infection was done. METHODS: Cervical fibronectin concentration in asymptomatic pregnant women between 23 and 31 weeks' gestation was determined. One hundred and sixty five singleton pregnant women with an initial positive fetal fibronectin test (>50 ng/mL) were divided into 4 groups. 1) Patients with two positive fibronectin tests (n=31); 2) Patients followed by a negative result (n=75); 3) Patients followed by a amniocentesis, not fibronectin test (n=31); 4) Patients followed no further study (n=28) The relationship between the results of serial testing and pregnancy outcome was determined. RESULTS: 1) Among women with an initial positive fetal fibronectin test, the rate of a second positive test within two weeks was 29.2% (31/106); 2) Women with two positive results had a higher rate of spontaneous preterm delivery before 34 weeks and 37 weeks of gestation than women with a positive test followed by a negative test (34 weeks: 13.8% (4/29) vs 2.7% (2/75) p<0.05, 37 weeks: 27.6% (8/29) vs 8.1% (6/74) p=0.02); 3) Among women with a positive fibronectin followed by a negative test, 91.9% (68/74) delivered at term and 97.3% (73/75) after 34 weeks of gestation. 4) In repeated positive results group, the change of concentration of fibronectin was not related to gestational age of delivery before 34 weeks. CONCLUSION: Patients with two positive fibronectin tests are at a higher risk of spontaneous preterm delivery than patients with a positive test followed by a negative result.
