|
KMID : 0388419990090010089
|
|
Konkuk Journal of Medical Sciences
1999 Volume.9 No. 1 p.89 ~ p.106
|
|
|
A Clinical Significance of Measuring Fetal Fibronectin, Cervical Dilatation and Length as a Predictor of Preterm Delivery
|
|
Chung Doo-Yong
Ryu Jung-Hyun
Bang Sae-Chang
Kim So-Jung
|
|
|
Abstract
|
|
|
Twenty seven pregnant women between 22 and 36 weeks of gestational age presenting with preterm labor, intact membrane and less than 3㎝ cervical dilatation visited the department of Obstetrics and Gynecology, Konkuk University Medical Center, Choongju Hospital from June 1, 1998 to March 31, 1999. These patients’ cervicovaginal swabs were assessed for the presence or absence of fetal fibronectin by means of ROM-CHECK(monoclonal antibody assay) the positivity of which was revealed by a colorimetric reaction. Also cervical parameters such as cervical length, presence of funneling, funnel length and funnel width were measured by transvaginal ultrasonography. We compared the diagnostic performances of these results in the prediction of preform delivery of patients with preform labor and intact membranes.
The results were as follows ; 1. The overall incidence of preterm delivery(< 37 weeks) was 44％; 12 among 27 patients.
2. There were statistically significant differences in the mean Bishop scores(4.58±0.48 vs 2.13±0.36), the mean gestational age at first admission with preterm labor(33.33±0.38 vs 29.47±1.06 weeks), the mean gestational age at delivery (34.92±0.34 vs 38.27±0.34 weeks) and interval from first admission to delivery(284.2±103.1 vs 1,339.2±154.4 hour) and mean birthweight(2,620±100 vs 3,131±100g) between the preform delivery group and term delivery group. 3. The positive rates of fetal fibronectin in the vaginal fluid of preform delivery group and term delivery group were 42% (5/12) and 0% (0/l5).
4. The mean cervical length, presence of cervical funneling, funnel length and funnel width were 22.25±2.61㎜ vs 30.67±1.63㎜ : 75% (9/12) vs 47% (7/15); 11.83±3.40㎜ vs 4.53±1.64㎜ : 11.50±2.92㎜ vs 6.07±1.87㎜ in preterm delivery group and term delivery group, and there were statistical significances in the mean values of cervical length and funnel length between each group. 5. The sensitivities and specificities of fetal fibronectin, cervical length(≤25㎜), cervical funnel length(≥10㎜) and width(≥16㎜) as a predictor of preterm delivery were 42% and 100%; 75% and 80%; 50% and 87%: 33% and 93%. The positive predictive values and negative predictive values of fetal fibronectin, cervical length(≤25㎜), cervical
funnel length(≥10㎜) and funnel width(≥16㎜) as a predictor of preform delivery were 100% and 68%, 75% and 80%; 75% and 68%; 80% and 64%. 6. The sensitivities and specificities of the combined use of fetal fibronectin, cervical length(≤25㎜), cervical funnel length(≥10㎜) and width(≥16㎜) as a predictor of preterm delivery were 83% and 67%. The positive predictive value and negative predictive value of the combination of fetal fibronectin, cervical length(≤25㎜), cervical
funnel length(≥10㎜) and width(≥16㎜) as a whole as a predictor of preterm delivery were 67% and 83%.
|
|
|
KEYWORD
|
|
|
preterm labor, fetal fibronectin, cervical length, cervical funneling
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|
|
|