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[识别早产风险:胎儿纤维连接蛋白的作用]

[Identification the risk of preterm labor :the role of fetal fibronectin].

作者信息

Karamisheva V, Ivanov St, Nikolov A, Jordanova D, Dimitrov G, Nachev A

出版信息

Akush Ginekol (Sofiia). 2015;54(1):3-6.

Abstract

UNLABELLED

Fibronectins represent a group of glycoproteins, which form "molecular glue" and are necessary in the interaction between a cell and a cell. The existence of fetal fibronectin in pregnant woman's vagina up to 22 g.w. is normal. In a normally proceeding pregnancy between 22 g.w. and 35 g.w. there is not supposed to be found fetal fibronectin in cervico-vaginal secretion. Its presence is a highly informative biological marker for the risk of premature birth.

AIM

The aim of this research was to determine the risk for premature birth through applying fetal fibronectin test as a specific marker to pregnant women with or withthout symptoms of threatened birth.

METHODS

A prospective longitudinal study has been carried out. The tests have been applied to hospitalized patients in University hospital "Majchin dom", Clinic of Pathologic pregnancy and Delivery room. Tests have been applied on 116 patients in totally). The pregnant have been separated in two groups depending on the fact of presence or absence of premature birth symptoms. The screening methods used were: the fFN test and the cervical length measurement by transvaginal according to an established protocol.

CONCLUSION

From the total of 116 patients, in 78 we have received positive tests for fetal fibronectin; in 38 - negative test. With asymptomatic patients, having higher risk of preterm birth, the percent of positive tests has been lower (14%). With asymptomatic patients with higher percent of risk factors have been: short cervix (38%), multiple pregnancy (29%), followed by patients with diagnosis of preterm birth in the past (25%) and bleeding in earlier terms. Estimating positive and negative predictive rate, we have achieved following results: The test for fetal fibronectin has excellent predictive rate - 97%, which coincides with the great deal of research until this moment in the world. Referring to the positive predictive rate--it is not sufficient--only 19%.

摘要

未标注

纤连蛋白是一类糖蛋白,它们形成“分子胶水”,在细胞与细胞之间的相互作用中必不可少。妊娠22周前孕妇阴道中存在胎儿纤连蛋白是正常的。在妊娠22周和35周之间正常进行的妊娠中,宫颈阴道分泌物中不应发现胎儿纤连蛋白。其存在是早产风险的高度信息性生物标志物。

目的

本研究的目的是通过将胎儿纤连蛋白检测作为一种特定标志物应用于有或无先兆早产症状的孕妇,来确定早产风险。

方法

进行了一项前瞻性纵向研究。检测应用于大学医院“马金多姆”病理妊娠诊所和产房的住院患者。总共对116名患者进行了检测。根据是否存在早产症状,将孕妇分为两组。使用的筛查方法是:胎儿纤连蛋白检测和按照既定方案经阴道测量宫颈长度。

结论

在116名患者中,78名胎儿纤连蛋白检测呈阳性;38名检测呈阴性。对于早产风险较高的无症状患者,检测阳性率较低(14%)。早产风险因素比例较高的无症状患者有:宫颈短(38%)、多胎妊娠(29%),其次是既往有早产诊断的患者(25%)和早期出血。评估阳性和阴性预测率,我们得到了以下结果:胎儿纤连蛋白检测具有出色的预测率——97%,这与目前世界上大量的研究结果一致。至于阳性预测率——并不充分——仅为19%。

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