[Prediction of spontaneous preterm birth in symptomatic patients: A review]

Abstract

Objective of the review: To identify predictors of preterm delivery in the context of threatened preterm labour.

Main points: Tobacco use and previous history of preterm delivery are the main anamnestic elements to predict preterm birth. High positive predictive value of vaginal examination is restricted to cases with strong cervical alterations like dilatation over 4 cm. In case of discrete cervical alterations, literature confirms the great interest for cervical length ultrasonographic measurement as it reduces false positive cases. Absence of fetal respiratory movements appears to be as sensitive as cervical length and could be more specific but its clinical use remains rare. Vaginal detection of fetal fibronectin is the most useful biomarker with high negative predictive value (>90%). Fibronectin quantitative test seems to enhance the positive predictive value. No other biomarker is currently used in clinical practice. Electromyography and elastography of the cervix appear to be promising approaches.

Keywords: Cervical length; Fetal fibronectin; Fibronectine fœtale; Longueur cervicale échographique; Menace d’accouchement prématuré; Prediction of preterm birth; Preterm birth; Prédiction de l’accouchement prématuré; Prématurité; Threatened preterm labour.