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. 2020 Sep;33(17):2865-2871.
doi: 10.1080/14767058.2018.1562541. Epub 2019 Jan 13.

The utility of fetal fibronectin in asymptomatic singleton and twin pregnancies with a cervical length ≤ 10 mm

Noelia Zork  1 , Moti Gulersen  2 , Anne Mardy  3 , Caroline Pessel  4 , Sara Brubaker  5 , Joy Vink  1 , Cynthia Gyamfi-Bannerman  1 , Cande V Ananth  1   6
Affiliations

The utility of fetal fibronectin in asymptomatic singleton and twin pregnancies with a cervical length ≤ 10 mm

Noelia Zork et al. J Matern Fetal Neonatal Med. 2020 Sep.

Abstract

Objective: To examine the utility of fetal fibronectin (fFN) for predicting spontaneous preterm birth (PTB) in asymptomatic women with a cervical length (CL) ≤10 mm compared to those with a CL 11-25 mm.Methods: Data was collected on all women with nonanomalous singleton and twin gestations who underwent transvaginal CL at a single institution between 2009 and 2012. Women with an incidental short cervix (CL ≤ 25 mm) between 22 and 32 weeks who had an fFN result within 7 days thereafter were included. Indicated preterm deliveries at <14 days of fFN, women who underwent cerclage placement, and terminations of pregnancy were excluded. The primary outcome was spontaneous PTB within 7 and 14 days of the fFN. Sensitivity, specificity, and positive (PPV) and negative predictive value (NPV) of fFN for a CL ≤ 10 mm was calculated for singletons and twins and compared to those with a CL 11-25 mm.Results: Of the 213 women included, 117 (54.9%) were singletons and 96 (45%) were twins. Baseline characteristics were similar between those with a CL ≤ 10 mm and with a CL 11-25 mm in both singletons and twins. The NPV of fFN for delivery within 7 days in singletons and twins with a CL ≤ 10 mm was 100%, similar to those with a CL 11-25 mm (93-100%). The NPV of fFN for delivery within 14 days in singletons and twins with a CL ≤ 10 mm remained high (87.5-100%) when compared to those with a CL 11-25 mm (93-100%). The PPV of fFN for delivery within 7 and 14 days in both singletons and twins with a CL ≤ 10 mm was low (10-25%) and similar to those with a CL 11-25 mm (7.1-24.4%).Conclusions: The NPV of fFN in asymptomatic singleton and twin pregnancies with a CL ≤ 10 mm is high and comparable to the NPV of fFN in women with a longer CL. Routine fFN collection in this select population should be considered as it may avoid unnecessary and costly admissions, as well as assist with timing of antenatal corticosteroids.

Keywords: Cervical length; fetal fibronectin; preterm birth; short cervix.

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Conflict of interest statement

The authors report no conflict of interest.

Figures

I.
I.
Flow diagram illustrating the exclusion process in the study cohort. CL, cervical length; fFN, fetal fibronectin; GA, gestational age.
See this image and copyright information in PMC

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