Fetal fibronectin as a marker for an imminent (preterm) delivery. A new technique using the glycoprotein lectin immunosorbent assay

We have developed a new 'glycoprotein lectin immunosorbent assay' (GLIA) wh ich permits the obstetrician to identify accurately pregnant women at risk for preterm delivery. This GLIA uses two lectins for the quantitative detec tion of glycosylation variants of fibronectins, namely, Maackia amurensis l ectin (MAA) for the detection of fetal fibronectin (fFN), and Sambucus nigr a lectin (Elderberry bark lectin; SNA). Fibronectin was quantitated in cerv icovaginal secretions, amniotic fluid, and plasma of pregnant women. Detect ion of fFN in cervicovaginal secretions was considered to indicate a high r isk of imminent delivery. The results were as follows: (1) The GLIA could d ifferentiate between pregnant women after the onset of labour and/or with r upture of membranes and women without any signs of an imminent delivery (se nsitivity 94%, specificity 96%, p < 0.001). (2) Differentiation was possibl e between asymptomatic pregnant women delivering within 10 days of sampling or after more than 10 days (sensitivity 93%, specificity 99%; p < 0.001). (3) If fFN was present in the cervicovaginal secretions, delivery occurred within 10 days of sampling irrespective of preterm delivery or delivery at term (p < 0.001). Thus, this GLIA is a useful assay for identifying those a symptomatic pregnant women who will deliver within 10 days of sampling. (C) 1999 Elsevier Science B.V. All rights reserved.