Rinehart B K, Terrone D A, Isler C M, Barrilleaux P S, Bufkin L, Morrison J C
Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Mississippi Medical Center, Jackson, USA.
Am J Obstet Gynecol. 2001 Apr;184(5):1004-7. doi: 10.1067/mob.2001.112105.
This study was undertaken to determine pregnancy outcome in women who have preterm labor symptoms without cervical change according to fetal fibronectin status.
Patients who were examined at the obstetric emergency department with symptoms of preterm labor but without cervical change underwent fetal fibronectin collection. Pregnancy outcome and fetal fibronectin results were analyzed after delivery.
Of the 235 patients sampled, 20% (n = 48) had positive fetal fibronectin results. The mean +/- SD gestational age at delivery was lower in women with positive fetal fibronectin results (34.2 +/- 4.1 vs 37.7 +/- 2.3 weeks; P <.001); these women were more likely to deliver preterm as a result of preterm labor than women with other obstetric indications (46% vs 19%; P <.001). Infants born to these women demonstrated lower birth weight (2317 +/- 895 g vs 2877 +/- 557 g; P =.003), were more likely to be admitted to the neonatal intensive care unit (42% vs 14%; P <.001), and were more likely to die in the neonatal period (11% vs 0%; P <.001).
Patients with symptoms of preterm labor but without cervical change who have negative fetal fibronectin results are less likely to deliver preterm. Therefore in women with symptoms but without cervical change fetal fibronectin should be considered for risk assessment.
本研究旨在根据胎儿纤连蛋白状态确定有早产症状但宫颈无变化的女性的妊娠结局。
在产科急诊科接受检查、有早产症状但宫颈无变化的患者接受胎儿纤连蛋白检测。分娩后分析妊娠结局和胎儿纤连蛋白检测结果。
在抽样的235例患者中,20%(n = 48)胎儿纤连蛋白检测结果为阳性。胎儿纤连蛋白检测结果为阳性的女性分娩时的平均±标准差孕周较低(34.2±4.1周 vs 37.7±2.3周;P <.001);与有其他产科指征的女性相比,这些女性因早产而早产的可能性更大(46% vs 19%;P <.001)。这些女性所生婴儿出生体重较低(2317±895 g vs 2877±557 g;P =.003),更有可能入住新生儿重症监护病房(42% vs 14%;P <.001),且在新生儿期死亡的可能性更大(11% vs 0%;P <.001)。
有早产症状但宫颈无变化且胎儿纤连蛋白检测结果为阴性的患者早产的可能性较小。因此,对于有症状但宫颈无变化的女性,应考虑检测胎儿纤连蛋白进行风险评估。