Ness R B, McLaughlin M T, Heine R P, Bass D C, Mortimer L
Graduate School of Public Health, University of Pittsburgh, Pennsylvania 15261, USA.
Am J Obstet Gynecol. 1998 Sep;179(3 Pt 1):697-702. doi: 10.1016/s0002-9378(98)70067-5.
Our purpose was to determine the accuracy of fetal fibronectin values for diagnosing ectopic pregnancies.
We obtained vaginal swabs from women with pregnancies of < or = 12 weeks' gestation to perform enzyme-linked immunosorbent assays for fetal fibronectin. Fetal fibronectin values were compared among groups categorized on the basis of clinical and laboratory criteria into (1) ectopic pregnancies, (2) threatened abortions, (3) incomplete/complete abortions, and (4) uncomplicated intrauterine pregnancies.
Mean fetal fibronectin values ranged from 0.08 microg/mL in women with ectopic pregnancies to 0.33 microg/mL in women with threatened abortions. Comparing these two diagnostic categories, a negative fetal fibronectin test (at a cutoff level of 0.300 microg/mL) predicted ectopic pregnancy with a sensitivity of 94%, specificity of 28%, positive predictive value of 62%, and negative predictive value of 78%.
Although fetal fibronectin is low in women with ectopic pregnancies, a negative test is not sufficiently sensitive and specific to be used clinically for the diagnosis of ectopic pregnancy.
我们的目的是确定胎儿纤连蛋白值对诊断异位妊娠的准确性。
我们从妊娠≤12周的女性中获取阴道拭子，以进行胎儿纤连蛋白的酶联免疫吸附测定。根据临床和实验室标准将研究对象分为以下几组：（1）异位妊娠组，（2）先兆流产组，（3）不全/完全流产组，（4）未合并症的宫内妊娠组，比较各组的胎儿纤连蛋白值。
胎儿纤连蛋白的平均水平范围为：异位妊娠女性为0.08微克/毫升，先兆流产女性为0.33微克/毫升。比较这两个诊断类别，胎儿纤连蛋白检测结果为阴性（临界值为0.300微克/毫升）时，预测异位妊娠的灵敏度为94%，特异度为28%，阳性预测值为62%，阴性预测值为78%。
尽管异位妊娠女性的胎儿纤连蛋白水平较低，但检测结果为阴性时，其灵敏度和特异度不足以用于临床诊断异位妊娠。
