The effect of blood staining on cervicovaginal quantitative fetal fibronectin concentration and prediction of spontaneous preterm birth

Hezelgrave, Natasha L.; Kuhrt, Katy; Cottam, Kate; Seed, Paul; Tribe, Rachel M.; Shennan, Andrew

doi:10.1016/j.ejogrb.2016.11.027

Cited by 16 publications

(13 citation statements)

References 8 publications

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“…The detection fFN in cervicovaginal secretions is a marker for disruption of choriodecidual interface which could provide a clue for the delivery route favoring the vaginal birth (14). It has a high negative predictive value and an excellent "rule out" test for preterm delivery (15). We also found that the negative fFN results were associated with cesarean delivery.…”

Section: Discussionmentioning

confidence: 57%

Does Fetal Fibronectin Predict the Delivery Route in Nulliparous Women at Postterm Induced by Dinoprostone?

Çelik

Engin

Yıldırım

2020

Gynecol Obstet Reprod Med

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OBJECTIVE: Digital cervical evaluation has been used to determine the likelihood of vaginal delivery which is considered by many women to be non-tolerable. Recently, alternative approaches such as transperineal ultrasound, fetal fibronectin test in cervicovaginal secretions have been investigating for the prediction of the delivery route. We aimed to study whether the usefulness of qualitative fetal fibronectin test in cervicovaginal secretions for the prediction of vaginal delivery in pregnant women at postterm induced with dinoprostone. STUDY DESIGN:A total of 32 nulliparous pregnant women at postterm were enrolled in this prospective observational study. Fetal fibronectin test was applied to all participated women before the induction with dinoprostone and transvaginal ultrasonography was performed to measure cervical length. RESULTS:The women having positive fetal fibronectin test result gave birth through vaginal route, except one case. Although there is no statistically significant difference, the shorter cervical length was associated with vaginal delivery in our population. CONCLUSION:Fetal fibronectin test has a predictive value for delivery route in nulliparous women at postterm. Fetal fibronectin test may be used as a "rule out" test because the rate of fetal fibronectin positivity was found to be higher in patients who gave birth via vaginal route. As also shown in our study, although there is no statistically significant difference, the pregnant women with shorter cervical length might have a high possibility to achieve vaginal delivery.

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Section: Discussionmentioning

confidence: 57%

Does Fetal Fibronectin Predict the Delivery Route in Nulliparous Women at Postterm Induced by Dinoprostone?

Çelik

Engin

Yıldırım

2020

Gynecol Obstet Reprod Med

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“…All women were asymptomatic of preterm birth at the time of participation. Women were included even if they had had recent vaginal bleeding, as this has been shown to only have a small detrimental effect on the prediction of preterm birth by qfFN . Participants were not recruited if they reported intercourse in the previous 48 hours, as this reduces the reliability of qfFN .…”

Section: Methodsmentioning

confidence: 99%

Effect of QUiPP prediction algorithm on treatment decisions in women with a previous preterm birth: a prospective cohort study

Goodfellow

Care

Sharp

et al. 2019

BJOG

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Objective The QUiPP algorithm combines cervical length, quantitative fetal fibronectin (qfFN) and medical history to quantify risk of preterm birth. We assessed the utility of QUiPP to inform preterm birth prevention treatment decisions. Design A prospective cohort study with a subsequent impact assessment using the QUiPP risk of birth before 34 weeks’ gestation. Setting A UK tertiary referral hospital. Sample In all, 119 women with previous spontaneous preterm birth (sPTB) or preterm premature rupture of membranes (PPROM) before 34 weeks’ gestation. Methods Cervical length and qfFN were measured at 19+0 to 23+0 weeks’ gestation. Clinical management was based on history and cervical length. After birth, clinicians were unblinded to qfFN results and QUiPP analysis was undertaken. Main outcome measures Predictive statistics of QUiPP algorithm using 10% risk of sPTB before 34+0 weeks as treatment threshold. Results Fifteen of 119 women (13%) had PPROM or sPTB before 34 weeks. Of these, 53% (8/15) had QUiPP risk of sPTB before 34+0 weeks above 10%. Applying this treatment threshold in practice would have doubled our treatment rate (20 versus 42%). QUIPP threshold of 10% had positive likelihood ratio (LR) of 1.3 (95% CI 0.76–2.18), and negative LR of 0.8 (95% CI 0.45–1.40) for predicting sPTB before 34+0 weeks. Conclusions Use of the QUiPP algorithm in this population may lead to substantial increase in interventions without evidence that currently available treatment options are beneficial for this particular group. Tweetable abstract Independent study finds that the QUiPP algorithm could lead to substantial increases in treatment without evidence of benefit.

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“…While testing fetal fibronectin, blood-stained swabs were still effective in predicting PB; however they had higher false positive rates [ 50 ].…”

Section: Biomarkersmentioning

confidence: 99%

Prediction of Preterm Birth: Maternal Characteristics, Ultrasound Markers, and Biomarkers: An Updated Overview

Kaplan

Özgü-Erdinç

2018

Journal of Pregnancy

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There is not a single or combined screening method for preterm birth with high sensitivity which will truly identify the women at risk for preterm birth while also with high specificity to prevent unnecessary interventions and high treatment costs. Measurement of cervical length is the most cost-effective method that is used in clinical practice. Bedside tests have also been developed for detecting markers like fetal fibronectin, insulin-like growth factor binding protein-1 (IGFBP-1), interleukin-6, and placental alpha-macroglobulin-1. Taking the maternal history, health condition, and sociodemographical factors into consideration is recommended. Ultrasound markers apart from cervical length measurements as uterocervical angle and placental strain ratio are studied. Investigations on metabolomics, proteomics, and microRNA profiling have brought a new aspect on this subject. Maybe in the future, with clear identification of women at true risk for preterm birth, development of more effective preventive strategies will not be unfeasible.

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The effect of blood staining on cervicovaginal quantitative fetal fibronectin concentration and prediction of spontaneous preterm birth

Cited by 16 publications

References 8 publications

Does Fetal Fibronectin Predict the Delivery Route in Nulliparous Women at Postterm Induced by Dinoprostone?

Does Fetal Fibronectin Predict the Delivery Route in Nulliparous Women at Postterm Induced by Dinoprostone?

Effect of QUiPP prediction algorithm on treatment decisions in women with a previous preterm birth: a prospective cohort study

Prediction of Preterm Birth: Maternal Characteristics, Ultrasound Markers, and Biomarkers: An Updated Overview

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