The Correlation between Fetal Fibronectin, Bacterial Vaginosis and Cervical Length in Prediction of Preterm Labour

Abstract

Objective: To evaluate the diagnostic value of the cervical length (CL), fetal fibronectin (fFN) in the cervicovaginal secretion and Bacterial vaginosis (BV) infection in prediction of labor in women with threatened preterm labor (TPTL). Patients and methods: One hundred women (100) with TPTL included in this prospective study, which conducted in AL-AZHAR University, department of obstetrics and gynecology after approval of the study by the institute ethical committee and after informed consent. Women included in the study subjected to through history, general and abdominal examinations followed by collection of cervico-vaginal fluid sample for fFN assay, vaginal swab for detection of BV and TVS assessment of the cervical length. Collected data regarding, the cervical length, fFN and BV statistically analyzed to evaluate the diagnostic value of the cervical length, fFN and BV in prediction of labor in women with TPTL. Results: fFN had 86.6% sensitivity, 55.5% specificity, 52% PPV, 88.2% NPV and 64.2% accuracy for detection of labor within one week and the CL measured by TVS had 94.4% sensitivity, 77.7% specificity, 73.9% PPV, 95.4% NPV and 48.4% accuracy for detection of PTL within one week. Sensitivity, positive and negative predictive values were higher for the CL than fFN for detection of PTL within one week. However, the accuracy was better for fFN than the cervical length measured by TVS (64.2% versus 48.4%). Conclusion: fFN concentration in the cervico-vaginal secretion and CL measured by TVS were good predictors for PTL in women with TPTL. The CL at 25 mm cut-off between 28 and 35 weeks gestation had high sensitivity, high positive and negative predictive values than fFN in prediction of PTL, while the fFN was more accurate than the CL.