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胎儿纤连蛋白和宫颈长度作为足月妊娠自然发动分娩的预测指标

Fetal Fibronectin and Cervical Length as Predictors of Spontaneous Onset of Labour and Delivery in Term Pregnancies.

作者信息

Grab Delia, Doroftei Bogdan, Grigore Mihaela, Nicolaiciuc Ovidiu Sebastian, Anton Sorana Caterina, Simionescu Gabriela, Maftei Radu, Bolota Maria, Ilea Ciprian, Costachescu Gabriel, Anton Emil

机构信息

Department of Obstetrics and Gynecology, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania.

Clinical Department, Clinical Hospital of Obstetrics and Gynecology "Cuza Voda", 700038 Iasi, Romania.

出版信息

Healthcare (Basel). 2022 Jul 20;10(7):1349. doi: 10.3390/healthcare10071349.

Abstract

(1) Objective: This study aimed to determine whether qualitative fetal fibronectin and transvaginal sonographic measurement of cervical length are effective in predicting delivery in term pregnancies within 5 days of the test. (2) Methods: We examined 268 women with singleton pregnancies presenting themselves at 37+0−40+4 weeks (median 38 weeks + 1 day) of gestation with irregular and painful uterine contractions, intact membranes and cervical dilatation less than 2 cm. All women were admitted to hospital up to 72 h after birth. On admission, a qualitative fetal fibronectin test was performed in cervicovaginal secretions and transvaginal sonographic measurement of cervical length was carried out. The primary outcome measure was delivery within 5 days of presentation. RESULTS: Among the women who delivered within 5 days after admission, 65.2% had positive fFN assessment, 43.5% had cervical length below 26 mm, 52.2% had the age > 32.5 years, 34.8% were nulliparous and 56.5% had gestational age ≥ 275 days. Logistic regression analysis demonstrated that significant contributors to the prediction of delivery within 5 days were fibronectin positivity, cervical length ≤ 26 mm, maternal age > 32.5 years and gestational age ≥ 275 days, with no significant contribution from parity. (3) Conclusions: Qualitative fetal fibronectin test and transvaginal cervical length measurement in term pregnancies are useful tests for predicting spontaneous onset of labour within 5 days. It helps women and healthcare providers to determine the optimum time for hospital admission.

摘要

(1) 目的:本研究旨在确定定性胎儿纤连蛋白检测及经阴道超声测量宫颈长度对预测检测后5天内足月妊娠分娩是否有效。(2) 方法:我们检查了268名单胎妊娠女性,她们在妊娠37⁺⁰至40⁺⁴周(中位孕周38周⁺¹天)时出现不规律且伴有疼痛的子宫收缩,胎膜完整,宫颈扩张小于2 cm。所有女性在分娩后72小时内入院。入院时,对宫颈阴道分泌物进行定性胎儿纤连蛋白检测,并进行经阴道超声测量宫颈长度。主要结局指标是就诊后5天内分娩。结果:在入院后5天内分娩的女性中,65.2%的胎儿纤连蛋白检测结果为阳性,43.5%的宫颈长度低于26 mm,52.2%的年龄大于32.5岁,34.8%为初产妇,56.5%的孕周≥275天。逻辑回归分析表明,预测5天内分娩的重要因素是纤连蛋白阳性、宫颈长度≤26 mm、产妇年龄>32.5岁和孕周≥275天,而产次无显著影响。(3) 结论:足月妊娠时定性胎儿纤连蛋白检测和经阴道测量宫颈长度是预测5天内自然临产的有用检测方法。它有助于女性和医疗保健提供者确定最佳入院时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c5a/9320260/f934d32b3e5b/healthcare-10-01349-g001.jpg

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