TY - JOUR
T1 - Predictive value of cervical length measurement and fibronectin testing in threatened preterm labor
AU - Van Baaren, Gert Jan
AU - Vis, Jolande Y.
AU - Wilms, Femke F.
AU - Oudijk, Martijn A.
AU - Kwee, Anneke
AU - Porath, Martina M.
AU - Oei, Guid
AU - Scheepers, Hubertina C.J.
AU - Spaanderman, Marc E.A.
AU - Bloemenkamp, Kitty W.M.
AU - Haak, Monique C.
AU - Bolte, Antoinette C.
AU - Bax, Caroline J.
AU - Cornette, Jérôme M.J.
AU - Duvekot, Johannes J.
AU - Nij Bijvanck, Bas W.A.
AU - Van Eyck, Jim
AU - Franssen, Maureen T.M.
AU - Sollie, Krystyna M.
AU - Vandenbussche, Frank P.H.A.
AU - Woiski, Mallory
AU - Grobman, William A.
AU - Van Der Post, Joris A.M.
AU - Bossuyt, Patrick M.M.
AU - Opmeer, Brent C.
AU - Mol, Ben W.J.
PY - 2014/6
Y1 - 2014/6
N2 - OBJECTIVE:: To estimate the performance of combining cervical length measurement with fetal fibronectin testing in predicting delivery in women with symptoms of preterm labor. METHODS:: We conducted a prospective nationwide cohort study in all 10 perinatal centers in The Netherlands. Women with symptoms of preterm labor between 24 and 34 weeks of gestation with intact membranes were included. In all women, qualitative fibronectin testing (0.050-microgram/mL cutoff) and cervical length measurement were performed. Logistic regression was used to predict spontaneous preterm delivery within 7 days after testing. A risk less than 5%, corresponding to the risk for women with a cervical length of at least 25 mm, was considered as low risk. RESULTS:: Between December 2009 and August 2012, 714 women were enrolled. Fibronectin results and cervical length were available for 665 women, of whom 80 (12%) delivered within 7 days. Women with a cervical length of at least 30 mm or with a cervical length between 15 and 30 mm with a negative fibronectin result were at low risk (less than 5%) of spontaneous delivery within 7 days. Fibronectin testing in case of a cervical length between 15 and 30 mm additionally classified 103 women (15% of the cohort) as low risk and 36 women (5% of the cohort) as high risk. CONCLUSION:: Cervical length measurement, combined with fetal fibronectin testing in case of a cervical length between 15 and 30 mm, improves identification of women with a low risk to deliver spontaneously within 7 days.
AB - OBJECTIVE:: To estimate the performance of combining cervical length measurement with fetal fibronectin testing in predicting delivery in women with symptoms of preterm labor. METHODS:: We conducted a prospective nationwide cohort study in all 10 perinatal centers in The Netherlands. Women with symptoms of preterm labor between 24 and 34 weeks of gestation with intact membranes were included. In all women, qualitative fibronectin testing (0.050-microgram/mL cutoff) and cervical length measurement were performed. Logistic regression was used to predict spontaneous preterm delivery within 7 days after testing. A risk less than 5%, corresponding to the risk for women with a cervical length of at least 25 mm, was considered as low risk. RESULTS:: Between December 2009 and August 2012, 714 women were enrolled. Fibronectin results and cervical length were available for 665 women, of whom 80 (12%) delivered within 7 days. Women with a cervical length of at least 30 mm or with a cervical length between 15 and 30 mm with a negative fibronectin result were at low risk (less than 5%) of spontaneous delivery within 7 days. Fibronectin testing in case of a cervical length between 15 and 30 mm additionally classified 103 women (15% of the cohort) as low risk and 36 women (5% of the cohort) as high risk. CONCLUSION:: Cervical length measurement, combined with fetal fibronectin testing in case of a cervical length between 15 and 30 mm, improves identification of women with a low risk to deliver spontaneously within 7 days.
UR - http://www.scopus.com/inward/record.url?scp=84901623084&partnerID=8YFLogxK
U2 - 10.1097/AOG.0000000000000229
DO - 10.1097/AOG.0000000000000229
M3 - Article
C2 - 24807328
AN - SCOPUS:84901623084
SN - 0029-7844
VL - 123
SP - 1185
EP - 1192
JO - Obstetrics and Gynecology
JF - Obstetrics and Gynecology
IS - 6
ER -