[Fetal fibronectin in cervico-vaginal secretions--an indicator of incipient premature labor using a membrane immunoassay].

The objective of the investigation was to test the presence of foetal fibronectin in the cervicovaginal secretion in symptomatic pregnancies and assess the possible prediction of imminent premature delivery. Prospectively 84 pregnant women were examined who were admitted to hospital with symptoms of imminent premature delivery between the 24th and 34th week of pregnancy (more than 20 contractions per day or a cervical score higher than the critical value for the given week of gestation). The secretion was collected by means of a dacron brush from the posterior labium of the portio vaginalis uteri and examined by a single-use kit FFN (Fetal Fibronectin Membrane Immunoassay, Adeza Co.). From the total of 84 specimens of secretions examined for the presence of foetal fibronectin 32 were positive and 52 negative. Of 32 pregnant women with a positive test 19 women delivered within two weeks, 13 were discharged and the deliveries took place after the 36th week of pregnancy. In the group of 52 women with a negative result of the test 50 women were discharged and the deliveries occurred after the 36th week of gestation; only two women who remained in hospital had premature deliveries within two weeks after collection of the specimen. In no patient discharged from hospital delivery occurred before the end of the 36th week of gestation. The finding of positive foetal fibronectin can be interpreted only as an increased risk of premature delivery (positive predictive value 59.4%). A negative test has a better predictive value. If the test is negative, there is a 96.1% probability that premature delivery will not occur (negative predictive value).