CERVICOVAGINAL WASHING PROLACTIN ASSAY IN PREDICTION OF PRETERM DELIVERY

Objective: Our purpose was to determine the utility of cervicovaginal washing prolactin assay in prediction of preterm birth in women withou t rupture of membranes. Methods: Sixty-six women with normal singleton pregnancy were submitted to cericovaginal washing and serum prolactin assays. The latency period to delivery and gestational age at admissi on and at delivery were also recorded. According to uterine contractio ns and obstetrical history regarding the previous preterm delivery, th e pregnant women were divided into 4 groups: 18 symptomatic (group 1) and 15 asymptomatic (group 2) pregnancies who had previously had prete rm delivery, and 18 symptomatic (group 3) and 15 asymptomatic (group 4 ) pregnancies without a history of prior preterm delivery were enrolle d in the study. Results: The cervicovaginal washing prolactin concentr ations were significantly higher in groups 1 and 3 than in group 4 (P < 0.0083). With respect to the latency period to delivery and the birt h weeks, groups 2 and 4 were significantly higher than groups 1 and 3 (F < 0.0001). In the evaluation of the whole group, a significant nega tive correlation was observed both between cervicovaginal washing prol actin concentrations and the lapsed times to delivery, and the gestati onal ages at delivery. The finding of a cervicovaginal washing prolact in value exceeding 50 ng/ml in the 12 days preceding preterm delivery had sensitivity, specificity, positive and negative predictive values of 65%, 95%, 86%, and 81%, respectively. Conclusions: A cervicovaginal washing prolactin value more than 50 ng/ml precedes preterm delivery within 12 days at > 29 weeks. The easy application, the good feasibili ty, the success in identifying pregnancies at risk for preterm labor, and the cost effectiveness suggests cervicovaginal washing prolactin a ssay as a biochemical marker for preterm delivery. (C) 1997 Internatio nal Federation of Gynecology and Obstetrics.