FETAL FIBRONECTIN AS A PREDICTOR OF PRETERM DELIVERY IN TWIN GESTATIONS

Objective: To evaluate fetal fibronectin as a predictor of premature d elivery in twin pregnancies. Method: Cervicovaginal secretions were ob tained from 52 pregnant women with twin pregnancies between 24 and 34 weeks of gestation. The secretions were analyzed to detect the presenc e of fetal fibronectin by immediate-reading membrane test. The correla tion between the presence of fetal fibronectin and preterm birth was e valuated. In addition, cervical dilatation and effacement were evaluat ed with each sampling. Result: The sensitivity, specificity, positive predictive value and negative predictive value to predict preterm deli very were 89.3, 50.0, 67.6, and 80.0%, respectively. A positive fetal fibronectin result was associated with a relative risk (RR) for preter m birth of 3.4 (95% CI, 1.2-9.5). A positive fetal fibronectin test as sociated with cervical dilatation or effacement increased the RR for p reterm birth to 4.3 and 7.7, respectively, when compared with those wi th negative test and without cervical dilatation and effacement. Concl usion: Fetal fibronectin in the cervicovaginal secretions of patients with twin pregnancies is a sensitive predictor of preterm delivery. Ho wever, because of its low specificity, the fetal fibronectin test shou ld be evaluated along with cervical changes for better identification of twins likely to develop preterm labor. (C) 1998 International Feder ation of Gynecology and Obstetrics.