Objective To assess the accuracy of a single cervical fetal fibronectin test to predict spontaneous preterm Design A prospective blind cohort study.Setting Antenatal clinic of a teaching hospital in a Brussels semiurban area.Participants An unselected group of 170 women followed at the antenatal clinic.Methods A single cervical sample was obtained between 24 and 33 completed weeks of pregnancy. The fibronectin test was compared with clinical evaluation and their predictive properties were assessed.Results Fifteen women were excluded from the analysis because of elective preterm delivery for medical indications or loss to follow up. Of the 155 remaining women, nine (7%) had a spontaneous preterm delivery. For a single fetal fibronectin test, the sensitivity was 26.7%, the specificity 95.7%, and the positive and negative predictive values 40.0% and 92*4%, respectively. The likelihood ratio of a positive was similar to that of clinical predictors of preterm birth (LR = 6.2; 95% CI 2.0-19.6). Sensitivities were low for both clinical criteria and the fetal fibronectin test.Conclusions Because of low sensitivity in a low risk population, screening for preterm delivery should not be based on the result of a single fetal fibronectin test alone. However, due to its high specificity the test might be useful in avoiding unnecessary medical intervention.delivery in an unselected antenatal population.

No abstract

No abstract

Aim: Selective screening for gestational diabetes is still a subject of debate. The aim of this study was to determine the effectiveness of a selective screening strategy for diagnosing gestational diabetes in our setting. This strategy rests on a scoring system that assigns women to different risk categories according to the presence of risk factors such as overweight, older age and ethnicity. Methods: We compared the rate of diagnosed gestational diabetes according to universal screening and selective screening between two periods of time. Results: The selective screening strategy allowed only 15% of women to avoid screening and was associated with a 50% decrease in diagnosed gestational diabetes. Conclusion: The two-threshold approach did not detect similar proportions of women with gestational diabetes compared with universal screening. Half the cases were missed and most women still needed to be screened.

No abstract