Two‐step test: the combined use of fetal fibronectin and sonographic examination of the uterine cervix for prediction of preterm delivery in symptomatic patients

Hincz, Piotr; Wilczyński, J; Kozarzewski, M.; Szaflik, Krzysztof

doi:10.1034/j.1600-0412.2002.810111.x

Cited by 58 publications

(28 citation statements)

References 16 publications

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“…In contrast, Crane and associates 25 and Hincz and associates 23 reported that funneling was not an independent predictor of preterm delivery in symptomatic women. Hincz and colleagues 23 also observed that there was a higher incidence of funneling with the advance of gestational age, a finding that was first seen by Iams 30 , who reported that funneling is probably normal after 32 weeks of gestation.…”

Section: Transvaginal Sonography In Women With Symptoms Of Preterm Labormentioning

confidence: 90%

“…Two other studies compared the diagnostic performance of cervicovaginal fetal fibronectin (fFN) and transvaginal sonographic evaluation of the uterine cervix in symptomatic patients. They reported that the combined use of cervical ultrasonography and fFN testing improved the diagnostic efficiency of any of these methods alone 22,23 . Rozenberg and co-workers 24 , in a similar study of 76 symptomatic patients, failed to show any significant additional benefit from the performance of fFN testing over the single transvaginal ultrasonographic measurement of cervical length.…”

Section: Transvaginal Sonography In Women With Symptoms Of Preterm Labormentioning

confidence: 99%

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Ultrasonic measurements of the cervix and preterm labor

Antsaklis

2004

The Ultrasound Review of Obstetrics and Gynecology

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During the past few years a clear relationship has been established between decreased cervical length and risk of spontaneous preterm delivery. In this review, the most recent publications are described, and results are compared with those of the present authors regarding the prevention of preterm labor in both asymptomatic and symptomatic patients. Cervical assessment with ultrasound is now widely accepted and a well standardized method which can be easily performed in both high-and low-risk patients as a screening test for preterm delivery. It is the authors' belief that, for an evaluation of the cervix, all that is required is a well trained operator and a few minutes. TECHNIQUEThe cervix can be assessed by transabdominal, transvaginal or transperineal ultrasonography.

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Section: Transvaginal Sonography In Women With Symptoms Of Preterm Labormentioning

confidence: 90%

Section: Transvaginal Sonography In Women With Symptoms Of Preterm Labormentioning

confidence: 99%

Ultrasonic measurements of the cervix and preterm labor

Antsaklis

2004

The Ultrasound Review of Obstetrics and Gynecology

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“…With this sequential combined approach, the sensitivity and NPV to predict delivery within 28 days increased to 86% and 97%, respectively. 19 Gomez et al 20 also suggested adding the FFN test to improve the prediction of preterm delivery when the TVCL is <30 mm. The FFN test is currently underutilised in public and private hospitals in Hong Kong.…”

Section: -17mentioning

confidence: 99%

“…Thus, the FFN test could be helpful in women with undetermined TVCLs. Hincz et al 19 suggested using the test in women with TVCLs of 21 to 31 mm. With this sequential combined approach, the sensitivity and NPV to predict delivery within 28 days increased to 86% and 97%, respectively.…”

Section: -17mentioning

confidence: 99%

Fetal fibronectin test on Chinese women with symptoms of preterm labour: a pilot study

Cheung

Ngu²,

Lee³

2013

Hong Kong Med J

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Objective The fetal fibronectin test is advocated to facilitate the management of women presenting with threatened preterm labour, but is underutilised in Hong Kong. This study aimed to provide experience with this test and evaluate its utility in a local setting.Design Prospective cohort study.Setting A university-affiliated hospital in Hong Kong.Patients Women presenting with symptoms of preterm labour were recruited from 1 January 2011 to 30 June 2012. Main outcome measuresThe sensitivity, specificity, positive predictive value, and negative predictive value of the fetal fibronectin test to predict delivery within 24 hours, 48 hours, 7 days, and 14 days.Results A total of 22 women were recruited; 12 (55%) of whom had a negative fetal fibronectin test, none of whom delivered within 7 days; six received corticosteroids and tocolysis, one of whom delivered within 14 days. The 10 remaining women had a positive fetal fibronectin test. Five of whom delivered within 7 days and two within 14 days; all of them had received corticosteroids and tocolysis. For predicting delivery within 7 days, the sensitivity and negative predictive value of the test were both 100%.Conclusions Our study demonstrated the high negative predictive value of the fetal fibronectin test in our local setting, which suggests that it should be utilised more readily in women presenting with threatened preterm labour.

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“…Rizzo et al (1996) found that in the patients with cervical secretion fibronectin levels 60 ng/ml, survival analysis showed a shorter admission-to-delivery interval in the presence of an abnormal cervical index ( p 0.001). Hincz et al (2002) prospectively evaluated 82 patients with pre-term labour. In each case, fibronectin testing and sonographic examination of the cervix were performed.…”

Section: Economic Evaluationmentioning

confidence: 99%

The efficacy of fetal fibronectin testing in minimising hospital admissions, length of hospital stay and cost savings in women presenting with symptoms of pre-term labour

Dutta

Norman

2010

Journal of Obstetrics and Gynaecology

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The following review includes a number of studies on the effect of fetal fibronectin (fFN) testing and non-testing, as well as the positive and negative test results, some combining with transvaginal ultrasonographic measurement of cervical length primarily to reduce hospital admissions and length of hospital stay (with associated reduction in health service costs), in women presenting to hospital with symptoms of pre-term labour. English language medical literature was analysed using the search parameters: fetal fibronectin, cervical length, preterm labour, hospital admissions and length of stay. A total of 19 studies were included. Ten of these discussed the role of fFN in decreasing hospital admissions, transfers, length of stay and interventions like corticosteroids and tocolytics. Seven studies demonstrated a correlation of fFN testing with an actual estimate of cost savings of health resources. Five studies explored the combined predictability of fetal fibronectin and cervical length with regards to pre-term labour.

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Two‐step test: the combined use of fetal fibronectin and sonographic examination of the uterine cervix for prediction of preterm delivery in symptomatic patients

Abstract: The proposed combined use of the cervical sonography and fetal fibronectin testing is a practical diagnostic tool for predicting preterm delivery with higher sensitivity and negative predictive value than any of these methods alone.

Cited by 58 publications

References 16 publications

Ultrasonic measurements of the cervix and preterm labor

Ultrasonic measurements of the cervix and preterm labor

Fetal fibronectin test on Chinese women with symptoms of preterm labour: a pilot study

The efficacy of fetal fibronectin testing in minimising hospital admissions, length of hospital stay and cost savings in women presenting with symptoms of pre-term labour

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