Singer Emily, Pilpel Sylvia, Bsat Fadi, Plevyak Michael, Healy Andrew, Markenson Glenn
Department of Obstetrics and Gynecology and Division of Maternal Fetal Medicine, Baystate Medical Center, Springfield, Massachusetts, USA.
Obstet Gynecol. 2007 May;109(5):1083-7. doi: 10.1097/01.AOG.0000261896.20175.3a.
To investigate accuracy of fetal fibronectin testing to predict preterm birth in twin gestations with symptoms of preterm labor.
We reviewed charts of all patients with twin gestations who underwent fetal fibronectin testing and presented with complaints of preterm labor between January 1, 2000, and June 30, 2004. We also reviewed the charts of all singleton gestations with similar complaints that had fetal fibronectin testing between January 1, 2000, and December 31, 2001. All samples were processed using a rapid fetal fibronectin detection system. We calculated the sensitivity, specificity, positive predictive value, and negative predictive value of fetal fibronectin testing in singleton and twin gestations in predicting delivery within 14 days of testing.
Four hundred twenty-nine singletons and 87 twins met the inclusion criteria. The birth rate before 34 weeks of gestation for singletons was 3.5% compared with the rate of twin pregnancies of 28.7%. Fetal fibronectin predicted delivery within 14 days of testing with a sensitivity, specificity, and positive and negative predictive values in singleton gestations of 82%, 90%, 17%, and 99%, respectively. In twin gestations, fetal fibronectin predicted delivery within 14 days of testing with a sensitivity, specificity, and positive and negative predictive values of 71%, 74%, 19%, and 97%, respectively.
As noted in singleton pregnancies, fetal fibronectin testing in twins has a high negative predictive value. Fetal fibronectin evaluation may be a useful tool in screening twins with symptoms of preterm labor, because a negative result places these women at a low risk for delivering within 2 weeks of testing.
探讨胎儿纤连蛋白检测对预测有早产症状的双胎妊娠早产的准确性。
我们回顾了2000年1月1日至2004年6月30日期间所有接受胎儿纤连蛋白检测并伴有早产症状的双胎妊娠患者的病历。我们还回顾了2000年1月1日至2001年12月31日期间所有有类似症状并接受胎儿纤连蛋白检测的单胎妊娠患者的病历。所有样本均使用快速胎儿纤连蛋白检测系统进行处理。我们计算了单胎和双胎妊娠中胎儿纤连蛋白检测在预测检测后14天内分娩的敏感性、特异性、阳性预测值和阴性预测值。
429名单胎妊娠和87例双胎妊娠符合纳入标准。单胎妊娠在妊娠34周前的出生率为3.5%，而双胎妊娠的这一比率为28.7%。胎儿纤连蛋白预测检测后14天内分娩的情况，在单胎妊娠中的敏感性、特异性、阳性预测值和阴性预测值分别为82%、90%、17%和99%。在双胎妊娠中，胎儿纤连蛋白预测检测后14天内分娩的敏感性、特异性、阳性预测值和阴性预测值分别为71%、74%、19%和97%。
如在单胎妊娠中所指出的，双胎妊娠中胎儿纤连蛋白检测具有较高的阴性预测值。胎儿纤连蛋白评估可能是筛查有早产症状双胎妊娠的有用工具，因为阴性结果表明这些女性在检测后2周内分娩的风险较低。
