Chang T C, Chew T S, Pang M, Tan A C, Yeo G S
Department of Maternal Fetal Medicine, Singapore General Hospital, Singapore.
Ann Acad Med Singap. 1997 Nov;26(6):776-80.
The aim of this study was to evaluate the role of cervicovaginal fibronectin as a screening test in a low-risk population. Swabs were taken from the posterior fornix at 28 weeks gestation and foetal fibronectin levels were assayed using enzyme immunoassay. Eighteen patients (7.7%) delivered at less than 37 weeks of gestation, and 6 (2.4%) at less than 34 weeks of gestation. Five patients (2.1%) had a positive fibronectin test result. The sensitivity, specificity, positive predictive value and negative predictive value in the prediction of delivery less than 37 weeks of gestation were 16.7%, 99.1%, 60.0% and 93.4%, respectively. The sensitivity of foetal fibronectin in the prediction of delivery less than 34 weeks of gestation was higher (50%) compared with the prediction of delivery less than 37 weeks of gestation (16.7%). The low sensitivity of this test suggests a limited role for cervicovaginal fibronectin in the low-risk population. Further studies need to be carried out to assess whether multiple testing of cervicovaginal fibronectin at different gestational ages will further increase the sensitivity.
本研究的目的是评估宫颈阴道纤连蛋白作为低风险人群筛查试验的作用。在妊娠28周时从后穹窿采集拭子，并使用酶免疫测定法检测胎儿纤连蛋白水平。18名患者（7.7%）在妊娠37周前分娩，6名患者（2.4%）在妊娠34周前分娩。5名患者（2.1%）的纤连蛋白检测结果呈阳性。预测妊娠37周前分娩的敏感性、特异性、阳性预测值和阴性预测值分别为16.7%、99.1%、60.0%和93.4%。与预测妊娠37周前分娩（16.7%）相比，胎儿纤连蛋白预测妊娠34周前分娩的敏感性更高（50%）。该试验的低敏感性表明宫颈阴道纤连蛋白在低风险人群中的作用有限。需要进一步开展研究，以评估在不同孕周对宫颈阴道纤连蛋白进行多次检测是否会进一步提高敏感性。
