FETAL FIBRONECTIN AS A PREDICTOR OF PRETE RM BIRTH IN PATIENTS AT INCREASED RISK

The accuracy of cervicovaginal fetal fibronectin as a predictor of pre term birth was studied in patients with increased risk for preterm del ivery (according to the Creasy-score). In a prospective blind observat ional study the smear from the posterior fornix vaginae of 56 pregnant patients without FROM was examined using a quantitative immunoassay f or the detection of fetal fibronectin. The patients who tested positiv ely for fetal fibronectin had significantly more preterm deliveries th an those with a negative result (CHI square-test, p < 0.01, RR 5.1). O verall, sensitivity, specifity, positive and negative predictive value s were 56%, 87%, 45% and 91%, respectively. In patients with preterm l abor these values were 75%, 87%, 60% and 93%, respectively. No patient with a negative result delivered preterm during the following two wee ks. It is concluded that performing the fetal fibronectin test in pati ents with preterm labor is useful for the prediction of preterm birth. Routine testing in patients at increased risk (asymptomatic patients) is not recommended for lack of effectiveness.