Predictive Value of Cervical Length Measurement and Fibronectin Testing in Threatened Preterm Labor

Baaren, Gert Jan Van; Vis, Jolande Y.; Wilms, Femke F.; Oudijk, Martijn A.; Kwee, Anneke; Porath, Martina; Oei, Guid; Scheepers, Hubertina; Spaanderman, M.E.A.; Bloemenkamp, K.W.M.; Haak, Monique C.; Bolte, A.; Bax, Caroline J.; Cornette, J.; Duvekot, J.J.; Bijvanck, B.W. Nij; Eyck, Jim van; Franssen, Maureen; Sollie, Krystyna M.; Vandenbussche, Frank P.H.A.; Woiski, Mallory; Grobman, William A.; Post, J.A. van der; Bossuyt, Patrick M.; Opmeer, Brent C.; Mol, B. W.

doi:10.1097/01.aoa.0000463834.31552.e6

Cited by 25 publications

(72 citation statements)

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“…Further research is necessary to understand utility of quantification. Using CL in combination with quantitative fFN shows a slightly improved performance; yet, the best PPV achieved was 28% …”

Section: Introductionmentioning

confidence: 99%

“…Cervical length (CL) measurement via transvaginal ultrasound has been widely adopted throughout Europe. While it aids in categorizing women with a long cervix (>30 mm) as low risk and women with a short cervix (<15 mm) as very high risk, it fails to properly establish the risk when CL is equivocal . Several biomarkers have been investigated for this purpose.…”

Section: Introductionmentioning

confidence: 99%

“…We conducted this study to analyze whether the combined use of PAMG‐1 and CL measurement would improve identification of women at risk of imminent delivery in the equivocal cervical range between 15 and 30 mm. The parameter was chosen based on previous publications that indicated that patients with CL < 15 mm are at high risk (60–100%) of imminent delivery within 7 days, whereas patients with CL > 30 mm are at low risk (0.7–3%) of imminent delivery within 7 days . This is the first study to look at this population in combination with the PAMG‐1 test.…”

Section: Introductionmentioning

confidence: 99%

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Combined value of placental alpha microglobulin‐1 detection and cervical length via transvaginal ultrasound in the diagnosis of preterm labor in symptomatic patients

Bolotskikh

Borisova

2017

J of Obstet and Gynaecol

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AimWe aimed to evaluate the combined value of placental alpha microglobulin‐1 (PAMG‐1) and cervical length (CL) via transvaginal ultrasound for assessing risk of imminent spontaneous preterm delivery in patients presenting with threatened preterm labor (PTL).MethodsClinical exam, PAMG‐1 test, cardiotocography, and CL measurement via transvaginal ultrasound were performed on all patients meeting inclusion criteria. Ninety‐nine patients at 22+0–36+6 gestational weeks with the symptoms of PTL were included. The interval between sample collection and delivery was measured for each method.ResultsPerformance metrics were calculated for PAMG‐1 test, CL < 25 mm, and contractions ≥ 8/h. The sensitivity, specificity, positive predictive value, and negative predictive value for the PAMG‐1 test were 100%, 95%, 75%, 100% and 100%, 98%, 88%, 100% for 7 and 14 days, respectively; the respective values for CL < 25 mm were 83%, 59%, 22%, 96% and 79%, 59%, 24%, 94% for 7 and 14 days; and those for contractions ≥ 8/h were 42%, 38%, 8%, 83% and 43%, 38%, 10%, 80% for 7 and 14 days. Specificity for the PAMG‐1 test was statistically significant (P < 0.001) in pairwise comparisons for all other methods. Patients were divided into four groups for analysis of PAMG‐1 test performance as follows: CL < 15 mm (100%, 100%, 100%, 100% and 100%, 100%, 100%, 100% for 7 and 14 days, respectively); CL < 25 mm (100%, 94%, 83%, 100% and 100%, 97%, 92%, 100% for 7 and 14 days, respectively); CL of 15–30 mm (100%, 95%, 64%, 100% and 100%, 97%, 82%, 100% for 7 and 14 days, respectively); and CL ≥ 30 mm (100%, 100%, 100%, 100% and 100%, 100%, 100%, 100% for 7 and 14 days, respectively).ConclusionThe use of the PAMG‐1 test in patients with a CL of 15–30 mm is highly predictive of imminent spontaneous preterm delivery in women presenting with threatened PTL and could save hospital resources.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Combined value of placental alpha microglobulin‐1 detection and cervical length via transvaginal ultrasound in the diagnosis of preterm labor in symptomatic patients

Bolotskikh

Borisova

2017

J of Obstet and Gynaecol

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“…24 In this cohort, women with a cervical length measurement >3.0 cm and a negative fetal fibronectin result were at low risk (<5%) of spontaneous preterm delivery within 7 days. 24 In this cohort, women with a cervical length measurement >3.0 cm and a negative fetal fibronectin result were at low risk (<5%) of spontaneous preterm delivery within 7 days.…”

mentioning

confidence: 76%

“…23,24 In the first study, a cohort of 195 women with threatened preterm labor (regular contractions, membranes intact, cervix <3 cm dilated) were enrolled at 24 to 36 weeks' gestation at 4 hospitals in the United Kingdom and 2 hospitals in South Africa. Of particular interest are 2 relatively large prospective cohort studies, in which fetal fibronectin screening was performed in conjunction with maternal cervical length measurement.…”

Section: Cervical Length Screening In Symptomatic Womenmentioning

confidence: 99%

Pros and Cons of Maternal Cervical Length Screening to Identify Women at Risk of Spontaneous Preterm Delivery

Parry

Elovitz

2014

Clinical Obstetrics &Amp; Gynecology

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Large randomized controlled trials have demonstrated that universal maternal cervical length screening and treatment with daily vaginal progesterone in women with short cervical length reduces the risk of preterm birth, but large numbers of women must be screened to prevent a relatively small number of preterm deliveries. Issues that should be considered while implementing universal cervical length screening include: (1) the standards of quality and reproducibility for transvaginal ultrasound cervical length ascertainment; and (2) the implications of screening on the application of therapeutic strategies to populations not known to benefit (so-called "indication creep"). Optimal strategies to employ cervical ultrasound and progesterone treatment might be revealed by additional studies investigating cervical length cutoffs, frequency of screening, selective screening in higher-risk groups, and the use of transabdominal cervical length screening as a surrogate for transvaginal cervical length screening.

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Cost‐effectiveness of diagnostic testing strategies including cervical‐length measurement and fibronectin testing in women with symptoms of preterm labor

Baaren

Vis

Wilms

et al. 2018

Ultrasound in Obstet & Gyne

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Predictive Value of Cervical Length Measurement and Fibronectin Testing in Threatened Preterm Labor

Abstract: Topics: Systems-based Practice, Obstetric Complications E lective repeat cesarean delivery (CD) contributes sig-

Cited by 25 publications

References 0 publications

Combined value of placental alpha microglobulin‐1 detection and cervical length via transvaginal ultrasound in the diagnosis of preterm labor in symptomatic patients

Combined value of placental alpha microglobulin‐1 detection and cervical length via transvaginal ultrasound in the diagnosis of preterm labor in symptomatic patients

Pros and Cons of Maternal Cervical Length Screening to Identify Women at Risk of Spontaneous Preterm Delivery

Cost‐effectiveness of diagnostic testing strategies including cervical‐length measurement and fibronectin testing in women with symptoms of preterm labor

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