RAPID FETAL FIBRONECTIN SWAB-TEST IN PRETERM LABOR PATIENTS TREATED BY BETAMIMETICS

Objective: A preliminary study to examine the value of a rapid fetal f ibronectin swab-test used as a bedside test in the prognosis of preter m labor. Study design: Women presenting with preterm labor and intact membranes and less than 3 cm dilated were enrolled in a single referal center. Cervicovaginal swabs were assessed for the presence dr absenc e of fetal fibronectin by means of a rapid monoclonal antibody assay t he positivity of which was revealed by a colorimetric reaction. Result s were compared with uterine contractions frequency, Bishop cervical s core, duration of tocolysis and interval to delivery. The predictive v alue of fetal fibronectin test for delivery within 7, 14 or 21 days fr om sampling and before 32 and 37 weeks' of gestation was assessed in t he two groups. Results: Among 124 eligible patients, 19 presented with a positive fibronectin test and 105 with a negative one. Gestational age at sampling, Bishop cervical score and duration of tocolysis were identical in the two groups. The number of contractions was significan tly lower and gestational age at delivery was significantly higher in the fibronectin negative group. Fetal fibronectin in cervicovaginal se cretions has a high sensitivity (89%) for delivery within 7 days. Abse nce of fetal fibronectin in cervicovaginal secretions of patients pres enting with uterine contractions could rule out preterm labor within 7 and 14 days with a predictive value of 99 and 95.2%, respectively. In negative fetal fibronectin patients, preterm delivery before 32 and 3 7 weeks' is unlikely to occur with a predictive value of 97 and 85%, r espectively. Conclusion: Cervicovaginal fetal fibronectin detected by a rapid bedside swab-test in women with symptoms of preterm labor comp ares favourably with quantitative assays and could prove useful in the management of preterm labor. This should be confirmed in a longer pro spective study. (C) 1997 Elsevier Science Ireland Ltd.