Gestational Age at Cervical Length and Fetal Fibronectin Assessment and the Incidence of Spontaneous Preterm Birth in Twins

2015 ◽  
Vol 34 (6) ◽  
pp. 977-984 ◽  
Author(s):  
Nathan S. Fox ◽  
Daniel H. Saltzman ◽  
Ariel Fishman ◽  
Chad K. Klauser ◽  
Simi Gupta ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Gestational Age ◽  
Cervical Length ◽  
Spontaneous Preterm Birth ◽  
Fetal Fibronectin

Prediction of spontaneous preterm birth in asymptomatic twin pregnancies with the use of combined fetal fibronectin and cervical length

2009 ◽  
Vol 201 (3) ◽  
pp. 313.e1-313.e5 ◽  
Author(s):  
Nathan S. Fox ◽  
Daniel H. Saltzman ◽  
Chad K. Klauser ◽  
Danielle Peress ◽  
Christina V. Gutierrez ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Cervical Length ◽  
Spontaneous Preterm Birth ◽  
Fetal Fibronectin ◽  
Twin Pregnancies

Midtrimester Cervical Length in Low-Risk Nulliparous Women for the Prediction of Spontaneous Preterm Birth: Should We Consider a New Definition of Short Cervix?

2021 ◽  
Author(s):  
Paul Guerby ◽  
Mario Girard ◽  
Geneviève Marcoux ◽  
Annie Beaudoin ◽  
Jean-Charles Pasquier ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Health Care Providers ◽  
Gestational Age ◽  
Roc Curve ◽  
Transvaginal Ultrasound ◽  
Cervical Length ◽  
Care Providers ◽  
Operating Characteristics ◽  
Spontaneous Preterm Birth ◽  
Nulliparous Women

Objective The study aimed to estimate the predictive value of midtrimester cervical length (CL) and the optimal cut-off of CL that should be applied with asymptomatic nulliparous women for the prediction of spontaneous preterm birth (sPTB). Study Design This is a prospective cohort study of asymptomatic nulliparous women with a singleton gestation. Participants underwent CL measurement by transvaginal ultrasound between 20 and 24 weeks of gestation. The participants and their health care providers remained blinded to the results of CL measurement. The primary outcomes were sPTB before 35 weeks and sPTB before 37 weeks. Receiver operating characteristics (ROC) curve analyses were performed. Analyses were repeated by using multiples of median (MoM) of CL adjusted for gestational age. Results Of 796 participants, the mean midtrimester CL was 40 ± 6 mm with a 1st, 5th, and 10th percentile of 25, 29, and 32 mm, respectively. ROC curve analyses suggest that a cut-off of 30 mm was the optimal CL to predict sPTB before 35 weeks (area under the ROC curve [AUC]: 0.70, 95% confidence interval [CI]: 0.56–0.85) and before 37 weeks (AUC: 0.70, 95% CI: 0.59–0.80). Midtrimester CL <30 mm could detect 35% of all sPTB before 35 weeks at a false-positive rate of 5% (relative risk: 9.1, 95% CI: 3.5–23.5, p < 0.001). We observed similar results using a cut-off of CL <0.75 MoM adjusted for gestational age. Conclusion A midtrimester CL cut-off of 30 mm (instead of 25 mm), or CL less than 0.75 MoM, should be used to identify nulliparous women at high risk of sPTB. Key Points

α and β-defensins and bacterial vaginosis as preterm birth predictors. A systematic review and meta-analysis.

2020 ◽  
Vol 2020 (4) ◽  
pp. 1-13
Author(s):  
Mariel Castillo-López ◽  
Keyword(s):  
Preterm Birth ◽  
Early Identification ◽  
Meta Analysis ◽  
Cervical Length ◽  
Premature Delivery ◽  
Spontaneous Preterm Birth ◽  
Fetal Fibronectin ◽  
Potential Damage ◽  
Type Of Delivery ◽  
Children Under 5

Preterm birth is an entity with potential damage to the newborn and it is the leading cause of mortality in children under 5 years old. Even though research on this topic has been increasing in the last decade, it has not reflected in a reduction in the incidence of this problem. Nowadays, raised cervical-vaginal fetal fibronectin concentration and short cervical length are considered the only predictors of spontaneous preterm birth [1], and given the adverse and severe consequences of preterm birth, the early identification of women with a higher risk of presenting this type of delivery is crucial for pregnancy care. Several studies have tried to find new inflammation markers that may allow the early identification of pregnant women at high risk of premature delivery, because as on many diseases, inflammatory mediators play a role on the pathophysiology of this entity. This literature review aims to discuss recent findings regarding to the association between the innate immune response, specifically β-defensins with preterm birth.

scholarly journals Detection of fetal fibronectin in twin pregnancies in relation to gestational age

1999 ◽  
Vol 117 (3) ◽  
pp. 121-124 ◽  
Author(s):  
Tenilson Amaral Oliveira ◽  
Carla Muniz Pinto de Carvalho ◽  
Eduardo de Souza ◽  
Corintio Mariani-Neto ◽  
Luiz Camano
Keyword(s):  
Preterm Birth ◽  
Relative Risk ◽  
Gestational Age ◽  
Premature Delivery ◽  
Spontaneous Preterm Birth ◽  
Clinical Value ◽  
Fetal Fibronectin ◽  
Predictive Values ◽  
Twin Pregnancies ◽  
Study Setting

CONTEXT: The presence of fetal fibronectin in the cervix or vagina has been investigated as a possible marker for the risk of preterm birth. Fetal fibronectin in cervical fluid can provide direct evidence of pathologic changes at the interface of fetal and maternal tissues. OBJECTIVE: To evaluate the presence of fetal fibronectin as a predictor of premature delivery in twin pregnancies in relation to gestational age. DESIGN: Acuracy study. SETTING: University referral unit. PARTICIPANTS: 52 pregnant women with twin pregnancies and gestational age of between 24 and 34 weeks. MAIN MEASUREMENTS: Sensivity, specifity, predictive values and relative risk ratios of the correlation between fetal fibronectin and preterm birth before 34 and 37 weeks using an immediate-reading membrane test on cervicovaginal secretions obtained from participants. RESULT: The sensitivity varied between 66.7% and 85.7%, whereas the specificity was from 58.3% to 81.8% according to gestational age at the time of sampling. The relative risk of spontaneous preterm birth after a positive fetal fibronectin test, as compared with a negative fetal fibronectin test, rose from 2.8 at 24-26 weeks to 4.1 at 27-30 weeks. Analyses of the risk of delivery before 34 weeks were not statistically significant. CONCLUSION: Fetal fibronectin in the cervicovaginal secretions of patients with twin pregnancies is a useful tool for the early identification of twin pregnancies likely to deliver before 37 weeks. However, the clinical value of the fibronectin test is limited because of low indices for prediction of delivery before 34 weeks. The best period for performing the fetal fibronectin test in twin pregnancies to predict preterm delivery is between 27 and 30 weeks.

Correlation of cervical length, fetal fibronectin, phIGFBP-1, and cytokines in spontaneous preterm birth up to 14 days from sampling

2015 ◽  
Vol 43 (5) ◽  
Author(s):  
Marija Hadži-Lega ◽  
Ana Daneva Markova ◽  
Milan Stefanovic ◽  
Mile Tanturovski
Keyword(s):  
Preterm Birth ◽  
Preterm Delivery ◽  
Preterm Labor ◽  
Cervical Length ◽  
Outcome Variable ◽  
Spontaneous Preterm Birth ◽  
Fetal Fibronectin ◽  
Tnf Α ◽  
Vaginal Swabs ◽  
The Relationship

AbstractThe aim of this study was to determine the relationship between sonographic cervical length, fetal fibronectin (fFN), phIGFBP-1 (actim partus test), cytokines (IL-6, IL-2R, and TNF-α), and spontaneous preterm birth (SPTB) up to 14 days from sampling.Fifty-eight patients were recruited in a period of 6 months from September 2013 until March 2014 with symptoms or complaints suggestive of preterm labor. Consenting women were treated according to usual hospital protocol, with addition of vaginal swabs taken for fetal fibronectin, phIGFBP-1 (actim partus test) and cervical IL6, IL2R, and TNF-α. The outcome variable was occurrence of preterm delivery within 14 days from the day of hospital admission.Thirty-six patients (62.07%) were delivered within 14 days from admission. Our results indicated that the cervical length significantly inversely correlates with the concentration of IL-6 in the CVF (Spearman’s coefficient R=–0.382, P<0.05). Cervical length also correlated with a positive phIGFBP-1 test, i.e., patients with a positive test had an average cervical length of 18.5±4.63 mm, which is significantly lower than patients with a negative test –23.43±7.39 mm (P=0.003).The studied biochemical markers were only moderately successful in the prediction of preterm delivery.

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