Fetal fibronectin (FFN) testing in symptomatic patients for preterm labor and mcdonald cerclage

Abstract

ObjectiveThe purpose of this study was to assess the utility of vaginal fFN screening in symptomatic patients with a McDonald cerclage.Study designA retrospective cohort of patients who underwent McDonald cerclage from 1998-2004 was performed. Patients tested with fFN due to increased pelvic pressure or symptomatic uterine contractions were included in the analysis.ResultsA total of 163 fFN tests were performed in 90 eligible patients, including 68 singleton and 22 twin pregnancies. Data were analyzed to examine for delivery in ≤2 weeks from the time of performance of a fFN test (Table I). One singleton pregnancy with a negative test was excluded from this analysis for non-spontaneous delivery within 2 weeks. In the setting of a McDonald cerclage and symptoms of preterm labor, fFN testing showed a specificity of 90.6 % and negative predictive value of 98.0% for delivery in a 2 week period. A separate analysis was performed to evaluate delivery ≤34 weeks (Table II). Four patients were excluded for delivery for medical indications prior to 34 weeks. For delivery prior to 34 weeks, fFN had a sensitivity of 50%, specificity of 87.5%, negative predictive value of 95.9%, and positive predictive value of 23.1%.ConclusionTable IDelivery ≤2 weeks of fFN testingDelivery ≤2 wkDelivery >2 wk+fFN015−fFN3144 Open table in a new tab Table IIDelivery at ≤34 weeksDelivery ≤34 wkDelivery >34 wkAll fFNs −370Any fFN +310 Open table in a new tab ObjectiveThe purpose of this study was to assess the utility of vaginal fFN screening in symptomatic patients with a McDonald cerclage. The purpose of this study was to assess the utility of vaginal fFN screening in symptomatic patients with a McDonald cerclage. Study designA retrospective cohort of patients who underwent McDonald cerclage from 1998-2004 was performed. Patients tested with fFN due to increased pelvic pressure or symptomatic uterine contractions were included in the analysis. A retrospective cohort of patients who underwent McDonald cerclage from 1998-2004 was performed. Patients tested with fFN due to increased pelvic pressure or symptomatic uterine contractions were included in the analysis. ResultsA total of 163 fFN tests were performed in 90 eligible patients, including 68 singleton and 22 twin pregnancies. Data were analyzed to examine for delivery in ≤2 weeks from the time of performance of a fFN test (Table I). One singleton pregnancy with a negative test was excluded from this analysis for non-spontaneous delivery within 2 weeks. In the setting of a McDonald cerclage and symptoms of preterm labor, fFN testing showed a specificity of 90.6 % and negative predictive value of 98.0% for delivery in a 2 week period. A separate analysis was performed to evaluate delivery ≤34 weeks (Table II). Four patients were excluded for delivery for medical indications prior to 34 weeks. For delivery prior to 34 weeks, fFN had a sensitivity of 50%, specificity of 87.5%, negative predictive value of 95.9%, and positive predictive value of 23.1%. A total of 163 fFN tests were performed in 90 eligible patients, including 68 singleton and 22 twin pregnancies. Data were analyzed to examine for delivery in ≤2 weeks from the time of performance of a fFN test (Table I). One singleton pregnancy with a negative test was excluded from this analysis for non-spontaneous delivery within 2 weeks. In the setting of a McDonald cerclage and symptoms of preterm labor, fFN testing showed a specificity of 90.6 % and negative predictive value of 98.0% for delivery in a 2 week period. A separate analysis was performed to evaluate delivery ≤34 weeks (Table II). Four patients were excluded for delivery for medical indications prior to 34 weeks. For delivery prior to 34 weeks, fFN had a sensitivity of 50%, specificity of 87.5%, negative predictive value of 95.9%, and positive predictive value of 23.1%. ConclusionTable IDelivery ≤2 weeks of fFN testingDelivery ≤2 wkDelivery >2 wk+fFN015−fFN3144 Open table in a new tab Table IIDelivery at ≤34 weeksDelivery ≤34 wkDelivery >34 wkAll fFNs −370Any fFN +310 Open table in a new tab