Hezelgrave Natasha L, Shennan Andrew H
Division of Women's Health, Kings College London, Women's Health Academic Centre, Kings Health Partners, London, UK.
Womens Health (Lond). 2016 Jan;12(1):121-8. doi: 10.2217/whe.15.74. Epub 2015 Dec 11.
Spontaneous preterm birth (sPTB) is the leading cause of neonatal morbidity and mortality globally. Accurate prediction of sPTB would enable targeting of interventions such as admission to hospital, antenatal corticosteroids, magnesium sulphate and in utero transfer as well as guiding prophylactic treatment (e.g., cerclage or progesterone). Measurement of fetal fibronectin concentration in the cervicovaginal fluid is a known predictor of sPTB. Traditionally a positive/negative test (defined by a threshold of 50 ng/ml), recent work has demonstrated improved prediction when used as a quantitative test, whereby the concentration of fetal fibronectin is measured by an automated bedside reader. This review examines the evidence surrounding the use of quantitative fetal fibronectin in asymptomatic women at high risk of sPTB, as well as those with symptoms of threatened sPTB.
自发性早产(sPTB)是全球新生儿发病和死亡的主要原因。准确预测sPTB将有助于针对性地采取干预措施,如住院、产前使用皮质类固醇、硫酸镁以及宫内转运,同时也能指导预防性治疗(如宫颈环扎术或使用孕酮)。测量宫颈阴道液中胎儿纤连蛋白的浓度是已知的sPTB预测指标。传统上采用阳性/阴性检测(以50 ng/ml为阈值),最近的研究表明,当将其用作定量检测时,预测效果会更好,即通过床边自动检测仪测量胎儿纤连蛋白的浓度。本综述探讨了在无症状但有sPTB高风险的女性以及有sPTB先兆症状的女性中使用定量胎儿纤连蛋白的相关证据。