Negative fetal fibronectin: Who is still treating for threatened preterm labor and does it help?
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Linda M. Peláez
Abstract
Objective: Fetal fibronectin (fFN) has a high negative predictive value for delivery in the next seven days in patients at risk for preterm birth. Providers sometimes disregard a negative result and manage the patient for threatened preterm labor. Our objective was to identify the rate at which patients with a negative fFN were managed for threatened preterm labor and if delivery outcomes were improved with such management.
Study design: Retrospective chart review of 111 patients at a single institution evaluated in the obstetrical triage unit for symptoms of threatened preterm labor with negative fFN results over a 19-month period between November 2004 and June 2006. Charts were reviewed for baseline patient characteristics such as gestational age at presentation to triage and fFN testing, prior obstetrical history, cervical examination and contraction frequency. Gestational age at delivery was documented. Rates of admission to the hospital and treatments for threatened preterm labor in this cohort were reviewed.
Results: Thirty-seven of patients (33%) with a negative fFN result were managed for threatened preterm labor (admitted to the hospital, given tocolytics, steroids, or intravenous antibiotics) by their provider. Patients undergoing these interventions were more likely to have cervical dilatation, effacement and were contracting more frequently. Only one of the patients delivered within 7 or 14 days of fFN testing. There was no advantage seen to management of threatened preterm labor in the setting of a negative fFN in terms of pregnancy prolongation, even when analyzing the patients with meaningful clinical findings (dilated 2 cm, effaced ≥80%, or contracting ≥12 times/h).
Conclusion: Patients with meaningful clinical findings suspicious for preterm labor are more likely to undergo interventions by their physicians in the face of a negative fFN. This management does not improve length of gestation.
©2008 by Walter de Gruyter Berlin New York
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Articles in the same Issue
- Recommendations and guidelines for perinatal practice
- Guideline for the use of antenatal corticosteroids for fetal maturation
- Original articles – Obstetrics
- The quality of intrapartum uterine activity monitoring
- Negative fetal fibronectin: Who is still treating for threatened preterm labor and does it help?
- Seroprevalence and risk factors associated with herpes simplex virus infection among pregnant women
- P-selectin in placenta and gestational myometrium: its measurements and hypothetical role in hemostasis of placental bed after labor
- Exodus-1 (CCL20): evidence for the participation of this chemokine in spontaneous labor at term, preterm labor, and intrauterine infection
- Original article – Fetus
- Increasing rates of sex-discordant twins no longer correspond to decreasing perinatal mortality rates
- Original articles – Newborn
- Disinfection of Burkholderia cepacia complex from non-touch taps in a neonatal nursery
- The combined detection of umbilical cord nucleated red blood cells and lactate: early prediction of neonatal hypoxic ischemic encephalopathy
- Hematological profile of Korean very low birth weight infants
- Integrated backscatter of the brain of preterm infants
- Opinion paper
- Pregnancy among young adolescents: trends, risk factors and maternal-perinatal outcome
- Short communication
- Omniview-SisPorto® 3.5 – a central fetal monitoring station with online alerts based on computerized cardiotocogram+ST event analysis
- Letters to the editor
- Prenatal supply of docosahexaenoic acid (DHA): should we be worried?
- Prenatal docosahexaenoic acid (DHA) and arachidonic acid (AA) supplementation better for neurodevelopment than supplementation with DHA only?
- Three episodes of acquired pure red cell aplasia restricted to pregnancy
- Congress Calendar
