The effect of transvaginal ultrasound, vaginal examination, or coitus on fetal fibronectin results: individual participant data from 6 cohort studies

Levy, Ariel T.; Quist‐Nelson, Johanna; Berghella, Vincenzo

doi:10.1016/j.ajogmf.2020.100170

Cited by 2 publications

(4 citation statements)

References 21 publications

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Section: Fetal Fibronectinmentioning

confidence: 99%

“… 82 Conversely, women reporting coitus 24 to 48 hr prior to fFN collection were up to five times more likely to have a positive qualitative result (RR 5.6; 95% CI 3.0–10.6), suggesting a sound rationale for discouraging testing in this setting. 82 …”

Section: Fetal Fibronectinmentioning

confidence: 99%

“…It identified a high overall proportion agreement between positive fFN specimens obtained before and after TVUS (93.4%) and sterile vaginal examination (88.5%), suggesting a minimal effect of these interventions on positive test results. 82 Conversely, women reporting coitus 24 to 48 hr prior to fFN collection were up to five times more likely to have a positive qualitative result (RR 5.6; 95% CI 3.0-10.6), suggesting a sound rationale for discouraging testing in this setting. 82 A secondary analysis of data obtained in the multicentre APOSTEL-1 (Alleviation of Pregnancy Outcome by Suspending of Tocolysis in Early Labour-1) study showed that multiple factors including sexual intercourse and vaginal examinations contributed to invalid test results, but statistical significance was only observed for vaginal bleeding at the time of testing (OR 4.5; 95% CI 1.7-12).…”

Section: Fetal Fibronectinmentioning

confidence: 99%

“…82 Conversely, women reporting coitus 24 to 48 hr prior to fFN collection were up to five times more likely to have a positive qualitative result (RR 5.6; 95% CI 3.0-10.6), suggesting a sound rationale for discouraging testing in this setting. 82 A secondary analysis of data obtained in the multicentre APOSTEL-1 (Alleviation of Pregnancy Outcome by Suspending of Tocolysis in Early Labour-1) study showed that multiple factors including sexual intercourse and vaginal examinations contributed to invalid test results, but statistical significance was only observed for vaginal bleeding at the time of testing (OR 4.5; 95% CI 1.7-12). 83 Hezelgrave et al's study of high-risk asymptomatic women found that median fFN concentrations in blood-stained swabs were significantly greater than case-matched controls (66ng/mL vs 7.5ng/mL, p<0.001) and that these swabs had greater sensitivity but lower specificity for predicting PTB.…”

Section: Fetal Fibronectinmentioning

confidence: 99%

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Preterm Birth: Screening and Prediction

Creswell,

Rolnik,

Lindow

et al. 2023

IJWH

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Preterm birth (PTB) affects approximately 10% of births globally each year and is the most significant direct cause of neonatal death and of long-term disability worldwide. Early identification of women at high risk of PTB is important, given the availability of evidence-based, effective screening modalities, which facilitate decision-making on preventative strategies, particularly transvaginal sonographic cervical length (CL) measurement. There is growing evidence that combining CL with quantitative fetal fibronectin (qfFN) and maternal risk factors in the extensively peer-reviewed and validated QUanititative Innovation in Predicting Preterm birth (QUiPP) application can aid both the triage of patients who present as emergencies with symptoms of preterm labor and high-risk asymptomatic women attending PTB surveillance clinics. The QUiPP app risk of delivery thus supports shared decision-making with patients on the need for increased outpatient surveillance, in-patient treatment for preterm labor or simply reassurance for those unlikely to deliver preterm. Effective triage of patients at preterm gestations is an obstetric clinical priority as correctly timed administration of antenatal corticosteroids will maximise their neonatal benefits. This review explores the predictive capacity of existing predictive tests for PTB in both singleton and multiple pregnancies, including the QUiPP app v.2. and discusses promising new research areas, which aim to predict PTB through cervical stiffness and elastography measurements, metabolomics, extracellular vesicles and artificial intelligence.

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Section: Fetal Fibronectinmentioning

confidence: 99%

Section: Fetal Fibronectinmentioning

confidence: 99%

Section: Fetal Fibronectinmentioning

confidence: 99%

Section: Fetal Fibronectinmentioning

confidence: 99%

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Preterm Birth: Screening and Prediction

Creswell,

Rolnik,

Lindow

et al. 2023

IJWH

View full text Add to dashboard Cite

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Laboratory Markers in the Prediction of Premature Birth

Popova,

Kozlov,

Sizova

et al. 2023

Journal of Preventive, Diagnostic and Treatment Strategies in Medicine

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The problem of premature birth (PB) remains topical for the practicing obstetrician-gynecologist. The study of marker proteins indicating an increased risk of PB is one of the relevant areas of interest in modern obstetrics. The review presents data on laboratory markers of the onset of PB. Information on the importance of laboratory tests in predicting this condition is presented. A literature review on databases Scopus, Web of Science, The Cochrane Library, and Russian Science Citation Index, with a description of the experience of Russian and foreign authors on the use of biochemical indicators in determining risks of PB, is led. The significance of indicators such as fetal fibronectin, placental α-microglobulin-1, phosphorylated insulin-like growth factor-binding protein-1 and other marker proteins, as well as cytokines and hormones in the diagnosis of this condition is described. The experience of using noninvasive rapid tests for the qualitative determination of analytes from cervicovaginal artery emissions is reported. The efficacy of the joint use of medical ultrasound data combined with the determination of the level of one of the laboratory predictors, which choice is reliant on the gestational period and the presence of complications, is estimated. The use of laboratory predictors to determine the risk of PB can significantly reduce the number of unjustifiable hospitalizations as well as the institution of tocolytic and hormonal therapy. Almost all of the predictors which are described have a high negative predictive value, which may help reduce unreasonable hospitalizing.

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The effect of transvaginal ultrasound, vaginal examination, or coitus on fetal fibronectin results: individual participant data from 6 cohort studies

Cited by 2 publications

References 21 publications

Preterm Birth: Screening and Prediction

Preterm Birth: Screening and Prediction

Laboratory Markers in the Prediction of Premature Birth

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