O'Brien J M, Peeler G H, Pitts D W, Salama M M, Sibai B M, Mercer B M
Department of Obstetrics and Gynecology, University of Tennessee, Memphis.
Am J Obstet Gynecol. 1994 Oct;171(4):1107-11. doi: 10.1016/s0002-9378(13)90045-4.
Our purpose was to determine whether the presence of prolactin in cervicovaginal washings is associated with preterm birth.
A cohort of 80 patients underwent a washing of the ectocervix and vaginal fornices with a normal saline solution. The cohort consisted of two groups: 40 inpatients requiring tocolysis and 40 asymptomatic outpatients. The saline solution aspirates were centrifuged, the supernatant was stored at -70 degrees C, and a radioimmunoassay for prolactin was run in batch fashion. A prolactin concentration greater than the detection limit of the assay was considered a positive test result.
Prolactin was identified in significantly more symptomatic patients than asymptomatic controls (50% vs 5%, p < 0.0001). In symptomatic patients cervicovaginal prolactin had an 80% positive predictive value and a 65% negative predictive value for delivery at < or = 34 weeks' gestation. Patients testing positive for prolactin had significantly shorter latency from testing to delivery (16 +/- 17 vs 34 +/- 24 days, p = 0.02) and had significantly lower birth weights (1985 +/- 729 vs 2583 +/- 696 gm, p = 0.01) compared with patients testing negative. Prolactin was also identified in two asymptomatic patients, both of whom were delivered before term.
Cervicovaginal prolactin is a biochemical marker for preterm delivery, a shorter latency period to delivery, and lower birth weight in symptomatic patients. This test may also prove to be a valuable marker for preterm birth in asymptomatic women.
我们的目的是确定宫颈阴道冲洗液中催乳素的存在是否与早产相关。
80例患者队列接受了用生理盐水冲洗宫颈外口和阴道穹窿。该队列由两组组成：40例需要进行宫缩抑制治疗的住院患者和40例无症状的门诊患者。将生理盐水吸出物离心，上清液储存在-70℃，并批量进行催乳素放射免疫测定。催乳素浓度高于测定检测限被视为阳性检测结果。
有症状患者中催乳素的检出率显著高于无症状对照组（50%对5%，p<0.0001）。在有症状患者中，宫颈阴道催乳素对于孕34周及以前分娩的阳性预测值为80%，阴性预测值为65%。与检测阴性的患者相比，催乳素检测呈阳性的患者从检测到分娩的潜伏期显著缩短（16±17天对34±24天，p=0.02），出生体重显著降低（1985±729克对2583±696克，p=0.01）。在两名无症状患者中也检测到催乳素，这两名患者均早产。
宫颈阴道催乳素是有症状患者早产、分娩潜伏期较短和出生体重较低的生化标志物。该检测对于无症状女性早产可能也是一个有价值的标志物。
