A comparison of speculum and nonspeculum collection of cervicovaginal specimens for fetal fibronectin testing

Stafford, Irene; Garite, Thomas J.; Dildy, Gary A.; Colon-Lucach, Alfredo; Williams, Colin P.; Bobritchi, Becky; Lapointe, Jerome; Blöch, D.

doi:10.1016/j.ajog.2008.02.013

Cited by 21 publications

(15 citation statements)

References 8 publications

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“…The bulk of information on the reliability of the fFN test to predict PTB came from studies relying on specimen collection using vaginal speculum to directly visualize the cervix uteri, hence this method became the standard technique approved by FDA to conduct fFN testing. Speculum examination, however, is troublesome and even intolerable for some women and should be conducted by a trained medical professional …”

Section: Discussionmentioning

confidence: 99%

“…On review of the literature, few studies have investigated the reliability of non‐speculum methods to collect cervicovaginal specimens for fFN testing (Table ) . In a retrospective study, Roman et al .…”

Section: Discussionmentioning

confidence: 99%

“…One of the drawbacks of this test is that it requires, as originally described, a speculum examination and sampling of cervicovaginal secretions under direct visualization; this makes the test difficult for some women and necessitates the presence of trained professional medical staff . The blind vaginal sampling technique has been described previously, and some considered it as efficient as the standard speculum‐directed technique while others did not . The main objective of the current study was to compare the accuracy of blind vaginal and cervicovaginal fetal fFN swabs to predict PTB among symptomatic women presenting with threatened PTL.…”

Section: Introductionmentioning

confidence: 99%

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Blind vaginal fetal fibronectin swab for prediction of preterm birth

Farag

Mohammed

Ellaithy

et al. 2015

J of Obstet and Gynaecol

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Aim: To assess the accuracy of blind vaginal swab in diagnosis of preterm labor (PTL) and prediction of subsequent occurrence of preterm birth (PTB). Methods: Eligible women who presented at 24-34 weeks of gestation with threatened PTL had their cervicovaginal secretions sequentially sampled for fetal fibronectin (fFN) using two types of swabbing techniques. The first swab was a blind vaginal swab collected without the aid of speculum, while the second one was a routine cervicovaginal swab. All participants were followed up until delivery. Results: fFN in both swabs was significantly higher in women who delivered before term compared with women who delivered at term. On regression analysis, r 2 = 0.735 and 0.785 for blind vaginal and cervicovaginal swabs respectively, while on receiver operating characteristic analysis the area under curve was 0.965 and 0.977, respectively, without a statistically significant difference. Using an fFN cut-off of ≥0.05 μg/dL, the sensitivity, specificity, positive predictive value and negative predictive value of blind vaginal swab to predict PTB were 53.9%, 91.9%, 70.0% and 85.0%, respectively; while those for cervicovaginal swab were 58.3%, 94.7%, 77.8% and 87.8%, respectively. Conclusions: In women presenting at 24-34 weeks of gestation with threatened PTL, blind vaginal fFN swab is as effective as cervicovaginal swab to predict PTB, but it is easier to perform and does not require doctor supervision.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Blind vaginal fetal fibronectin swab for prediction of preterm birth

Farag

Mohammed

Ellaithy

et al. 2015

J of Obstet and Gynaecol

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“…coitus, digital examination, vaginal ultra sound (Stafford et al, 2008)  Tests result would be invalid if the swab was contaminated by any lubricants, soaps or disinfectants (Stafford et al, 2008).…”

Section: Clinical Outcomesmentioning

confidence: 99%

Diagnosis of preterm labour: introducing the fetal fibronectin test

Ponting

Tomlin

2011

British Journal of Midwifery

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This paper reports on an innovation, within a maternity unit, to introduce a fetal fibronectin, point of care test, that will aid the clinician in correctly diagnosing preterm labour. In turn this will assist in developing an individual plan of care for each woman with suspected preterm labour, rather than treating each case with the same interventions regardless of subsequent outcomes.Fetal fibronectin (fFN) is a complex adhesive glycoprotein which can be detected in the cervicovaginal secretions of women during pregnancy. Its concentration varies throughout pregnancy, detectable before 24 weeks of pregnancy the concentration then dips below the minimum detectable level up to 34 weeks of pregnancy, unless the woman is in preterm labour.The fFN test was successfully introduced into clinical practice. Demonstrating that when used appropriately, on women with symptomatic suspected preterm labour, fFN testing can aid in accurate diagnosis and thereby avoid unnecessary, costly interventions. KEY PHRASES The majority of women (80%) who present with the signs and symptoms of preterm labour will go on to deliver at, or after, 37 weeks gestation (Morgan et al 2007) Interventions and treatments for this group of women can therefore be unnecessary and costly.

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“…In particular, fFN and CLM have been shown to have a good negative predictive value in regards to imminent preterm birth [4, 5]. PAMG-1 is a 34-kDa protein found within amniotic fluid throughout pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Use of cervicovaginal PAMG-1 protein as a predictor of delivery within seven days in pregnancies at risk of premature birth

Çekmez¹,

Grover²,

Haberal³

et al. 2017

BMC Pregnancy Childbirth

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BackgroundTo investigate the utility of vaginal placental alpha microglobulin-1 (PAMG-1) protein as a predictor of preterm delivery within 7 days in pregnancies at risk of premature birth.MethodsThis prospective study was performed in women at risk of premature birth. The levels of vaginal PAMG-1 and foetal fibronectin (fFN) and the transvaginal cervical length measurement (CLM) were investigated and compared.ResultsSeventy-two pregnant women were included in this study. The sensitivities of PAMG-1, fFN and CLM were 73.3, 73.6%, and 52.9%, respectively, while the specificities of PAMG-1, fFN and CLM were 92.9%, 94.3%, and 90.9%, respectively. The positive predictive values of PAMG-1, fFN and CLM were 73.3%, 82.3%, and 64.2%, respectively, and the negative predictive values of PAMG-1, fFN and CLM were 92.9%, 90.9%, and 86.2%, respectively.ConclusionThe diagnostic accuracy of PAMG-1 is similar to that of fFN in terms of preterm labour detection within 7 days.

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A comparison of speculum and nonspeculum collection of cervicovaginal specimens for fetal fibronectin testing

Cited by 21 publications

References 8 publications

Blind vaginal fetal fibronectin swab for prediction of preterm birth

Blind vaginal fetal fibronectin swab for prediction of preterm birth

Diagnosis of preterm labour: introducing the fetal fibronectin test

Use of cervicovaginal PAMG-1 protein as a predictor of delivery within seven days in pregnancies at risk of premature birth

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