Efficacy of Fibronectin in Cervical Secretions, Measurement of Cervical Length & Shape by Transvaginal Sonography and Vaginal Swab PCR in Preterm Labor: Useful Predictor of Preterm Delivery

Hur, J Y; Suh, H S; Park, Y K; Ju, K S; Chough, S Y; Sunwoo, Tae Won

Abstract

OBJECTIVE
Preterm labor and delivery is a largest problem in modern perinatology and the leading cause of neonatal mortality and morbidity in the world. The prediction of preterm labor is usually made by several methods but the rate of false positive diagnosis of preterm labor is very high.
METHODS
Total 62 primi or multiparous women seen between 22 and 34 weeks' gestational age with symptoms of preterm labor, intact membrane, and dilatation <3cm were enrolled. Accurate assessment of cervical length and shape was measured by transvaginal ultrasonography between the internal cervical Os and the external cervical Os. The cervicovaginal swabs were obtained and assayed for the presence of chlamydia trachomatis, mycoplasma hominis, ureaplasma urealyticum, and fetal fibronectin.
RESULTS
The incidence of preterm labor and delivery was increased with positive fibronectin(> 50ng/ml) and cervical length(<2.5cm) and 'V' shape(sensitivity: 91.2%, specificity: 68,0%, positive predictive value: 80,9%, negative predictive value: 85.0%). The preterm delivery rates were substantially higher among patients with positive results(chlamydia trachomatis, mycoplasma hominis, and ureaplasma urealyticum) than in those with negative results.
CONCLUSION
Our data were to assess the utility of cervicovaginal expression of fetal fibronectin, infection of chlamydia trachomatis, mycoplasma homonis & ureaplasma urealyticum, and measurement of cervical length and shape in the prediction of preterm labor. The results from this study suggested that positive fetal fibronectin, vaginal infection, and short cervical length in women who have preterm labors indicated a significant risk factor for preterm delivery, and a opposite results were a reassuring sign.