Eriksen N L, Parisi V M, Daoust S, Flamm B, Garite T J, Cox S M
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Texas Medical School, Houston.
Obstet Gynecol. 1992 Sep;80(3 Pt 1):451-4.
To determine whether fetal fibronectin is a sensitive test for the detection of amniotic fluid (AF) in women with rupture of the membranes.
In a multicenter clinical trial, pooling, ferning, and nitrazine tests were compared with fetal fibronectin in 339 women at term (study group) with a clinical history of rupture of the membranes and in 67 women at term receiving routine prenatal care (controls). Ruptured membranes was diagnosed if any two of the standard tests were positive. Fetal fibronectin in the cervicovaginal secretions was determined using a qualitative enzyme-linked immunosorbent assay test. Fetal fibronectin was considered positive at 50 ng/mL.
The sensitivity of fetal fibronectin in the women with ruptured membranes was 98.2%. No controls had ruptured membranes based on standard test results, but 13 women had fetal fibronectin present. The mean (+/- standard error) interval between sampling and delivery was significantly less in the women positive for fetal fibronectin (169.3 +/- 45.8 hours) than in those with no detectable fetal fibronectin (333.4 +/- 29.0 hours).
Fetal fibronectin is a sensitive test for detection of AF in the vagina and compares favorably to standard tests. Its low specificity suggests that the assay may detect an alteration in membrane integrity. In addition, in patients without rupture of the membranes, the interval between sampling and delivery is significantly shorter if fetal fibronectin is present. We speculate that the presence of fetal fibronectin in cervicovaginal secretions may be a marker for impending labor in gravidas without gross rupture of the membranes.
确定胎儿纤连蛋白检测是否为诊断胎膜破裂女性羊水渗漏的敏感方法。
在一项多中心临床试验中，对339名足月有胎膜破裂病史的女性（研究组）以及67名接受常规产前检查的足月女性（对照组）进行羊水集聚试验、羊齿状结晶试验、石蕊试纸试验，并与胎儿纤连蛋白检测作比较。若两项标准检测结果为阳性，则诊断为胎膜破裂。采用定性酶联免疫吸附试验检测宫颈阴道分泌物中的胎儿纤连蛋白。胎儿纤连蛋白浓度≥50 ng/mL被视为阳性。
胎膜破裂女性中胎儿纤连蛋白检测的敏感度为98.2%。基于标准检测结果，对照组中无胎膜破裂者，但有13名女性检测出胎儿纤连蛋白。胎儿纤连蛋白检测呈阳性的女性，其采样至分娩的平均（±标准误）间隔时间（169.3±45.8小时）显著短于未检测到胎儿纤连蛋白的女性（333.4±29.0小时）。
胎儿纤连蛋白检测是诊断阴道羊水渗漏的敏感方法，与标准检测相比具有优势。其低特异性表明该检测方法可能检测到胎膜完整性的改变。此外，在未发生胎膜破裂的患者中，若检测到胎儿纤连蛋白，则采样至分娩的间隔时间显著缩短。我们推测，宫颈阴道分泌物中存在胎儿纤连蛋白可能是未发生明显胎膜破裂的孕妇即将分娩的一个标志。
