Predictive Value of Cervical Length Measurement and Fibronectin Testing in Threatened Preterm Labor

G.J. van Baaren; J.Y. Vis; F.F. Wilms; M.A. Oudijk; A. Kwee; M.M. Porath; G. Oei; H.C.J. Scheepers; M.E.A. Spaanderman; K.W.M. Bloemenkamp; M.C. Haak; A.C. Bolte; C.J. Bax; J.M.J. Cornette; J.J. Duvekot; B.W.A. Nij Bijvanck; J. van Eyck; M.T.M. Franssen; K.M. Sollie; F.P.H.A. Vandenbussche; M. Woiski; W.A. Grobman; J.A.M. van der Post; P.M.M. Bossuyt; B.C. Opmeer

doi:10.1097/AOG.0000000000000229

Predictive Value of Cervical Length Measurement and Fibronectin Testing in Threatened Preterm Labor

G.J. van Baaren, J.Y. Vis, F.F. Wilms, M.A. Oudijk, A. Kwee, M.M. Porath, G. Oei, H.C.J. Scheepers, M.E.A. Spaanderman, K.W.M. Bloemenkamp, M.C. Haak, A.C. Bolte, C.J. Bax, J.M.J. Cornette, J.J. Duvekot, B.W.A. Nij Bijvanck, J. van Eyck, M.T.M. Franssen, K.M. Sollie, F.P.H.A. VandenbusscheM. Woiski, W.A. Grobman, J.A.M. van der Post, P.M.M. Bossuyt, B.C. Opmeer

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

OBJECTIVE: To estimate the performance of combining cervical length measurement with fetal fibronectin testing in predicting delivery in women with symptoms of preterm labor.

METHODS: We conducted a prospective nationwide cohort study in all 10 perinatal centers in The Netherlands. Women with symptoms of preterm labor between 24 and 34 weeks of gestation with intact membranes were included. In all women, qualitative fibronectin testing (0.050-microgram/mL cutoff) and cervical length measurement were performed. Logistic regression was used to predict spontaneous preterm delivery within 7 days after testing. A risk less than 5%, corresponding to the risk for women with a cervical length of at least 25 mm, was considered as low risk.

RESULTS: Between December 2009 and August 2012, 714 women were enrolled. Fibronectin results and cervical length were available for 665 women, of whom 80 (12%) delivered within 7 days. Women with a cervical length of at least 30 mm or with a cervical length between 15 and 30 mm with a negative fibronectin result were at low risk (less than 5%) of spontaneous delivery within 7 days. Fibronectin testing in case of a cervical length between 15 and 30 mm additionally classified 103 women (15% of the cohort) as low risk and 36 women (5% of the cohort) as high risk.

CONCLUSION: Cervical length measurement, combined with fetal fibronectin testing in case of a cervical length between 15 and 30 mm, improves identification of women with a low risk to deliver spontaneously within 7 days.

Original language	English
Pages (from-to)	1185-1192
Number of pages	8
Journal	Obstetrics and Gynecology
Volume	123
Issue number	6
DOIs	https://doi.org/10.1097/AOG.0000000000000229
Publication status	Published - 2014
Event	33rd Annual Scientific Pregnancy Meeting of the Society-for-Maternal-Fetal-Medicine (SMFM) - San Francisco, Canada Duration: 11 Feb 2013 → 16 Feb 2013

Keywords

FETAL FIBRONECTIN
DELIVERY
MODELS
BIRTH
WOMEN
METAANALYSIS
NIFEDIPINE
TOCOLYSIS
THERAPY

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10.1097/AOG.0000000000000229

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van Baaren, G. J., Vis, J. Y., Wilms, F. F., Oudijk, M. A., Kwee, A., Porath, M. M., Oei, G., Scheepers, H. C. J., Spaanderman, M. E. A., Bloemenkamp, K. W. M., Haak, M. C., Bolte, A. C., Bax, C. J., Cornette, J. M. J., Duvekot, J. J., Nij Bijvanck, B. W. A., van Eyck, J., Franssen, M. T. M., Sollie, K. M., ... Opmeer, B. C. (2014). Predictive Value of Cervical Length Measurement and Fibronectin Testing in Threatened Preterm Labor. Obstetrics and Gynecology, 123(6), 1185-1192. https://doi.org/10.1097/AOG.0000000000000229

@article{317c35e2a9a449e5be661cea41df6868,

title = "Predictive Value of Cervical Length Measurement and Fibronectin Testing in Threatened Preterm Labor",

abstract = "OBJECTIVE: To estimate the performance of combining cervical length measurement with fetal fibronectin testing in predicting delivery in women with symptoms of preterm labor.METHODS: We conducted a prospective nationwide cohort study in all 10 perinatal centers in The Netherlands. Women with symptoms of preterm labor between 24 and 34 weeks of gestation with intact membranes were included. In all women, qualitative fibronectin testing (0.050-microgram/mL cutoff) and cervical length measurement were performed. Logistic regression was used to predict spontaneous preterm delivery within 7 days after testing. A risk less than 5%, corresponding to the risk for women with a cervical length of at least 25 mm, was considered as low risk.RESULTS: Between December 2009 and August 2012, 714 women were enrolled. Fibronectin results and cervical length were available for 665 women, of whom 80 (12%) delivered within 7 days. Women with a cervical length of at least 30 mm or with a cervical length between 15 and 30 mm with a negative fibronectin result were at low risk (less than 5%) of spontaneous delivery within 7 days. Fibronectin testing in case of a cervical length between 15 and 30 mm additionally classified 103 women (15% of the cohort) as low risk and 36 women (5% of the cohort) as high risk.CONCLUSION: Cervical length measurement, combined with fetal fibronectin testing in case of a cervical length between 15 and 30 mm, improves identification of women with a low risk to deliver spontaneously within 7 days.",

keywords = "FETAL FIBRONECTIN, DELIVERY, MODELS, BIRTH, WOMEN, METAANALYSIS, NIFEDIPINE, TOCOLYSIS, THERAPY",

author = "{van Baaren}, G.J. and J.Y. Vis and F.F. Wilms and M.A. Oudijk and A. Kwee and M.M. Porath and G. Oei and H.C.J. Scheepers and M.E.A. Spaanderman and K.W.M. Bloemenkamp and M.C. Haak and A.C. Bolte and C.J. Bax and J.M.J. Cornette and J.J. Duvekot and {Nij Bijvanck}, B.W.A. and {van Eyck}, J. and M.T.M. Franssen and K.M. Sollie and F.P.H.A. Vandenbussche and M. Woiski and W.A. Grobman and {van der Post}, J.A.M. and P.M.M. Bossuyt and B.C. Opmeer",

year = "2014",

doi = "10.1097/AOG.0000000000000229",

language = "English",

volume = "123",

pages = "1185--1192",

journal = "Obstetrics and Gynecology",

issn = "0029-7844",

publisher = "Lippincott Williams & Wilkins",

number = "6",

note = "33rd Annual Scientific Pregnancy Meeting of the Society-for-Maternal-Fetal-Medicine (SMFM) ; Conference date: 11-02-2013 Through 16-02-2013",

}

van Baaren, GJ, Vis, JY, Wilms, FF, Oudijk, MA, Kwee, A, Porath, MM, Oei, G, Scheepers, HCJ, Spaanderman, MEA, Bloemenkamp, KWM, Haak, MC, Bolte, AC, Bax, CJ, Cornette, JMJ, Duvekot, JJ, Nij Bijvanck, BWA, van Eyck, J, Franssen, MTM, Sollie, KM, Vandenbussche, FPHA, Woiski, M, Grobman, WA, van der Post, JAM, Bossuyt, PMM & Opmeer, BC 2014, 'Predictive Value of Cervical Length Measurement and Fibronectin Testing in Threatened Preterm Labor', Obstetrics and Gynecology, vol. 123, no. 6, pp. 1185-1192. https://doi.org/10.1097/AOG.0000000000000229

TY - JOUR

T1 - Predictive Value of Cervical Length Measurement and Fibronectin Testing in Threatened Preterm Labor

AU - van Baaren, G.J.

AU - Vis, J.Y.

AU - Wilms, F.F.

AU - Oudijk, M.A.

AU - Kwee, A.

AU - Porath, M.M.

AU - Oei, G.

AU - Scheepers, H.C.J.

AU - Spaanderman, M.E.A.

AU - Bloemenkamp, K.W.M.

AU - Haak, M.C.

AU - Bolte, A.C.

AU - Bax, C.J.

AU - Cornette, J.M.J.

AU - Duvekot, J.J.

AU - Nij Bijvanck, B.W.A.

AU - van Eyck, J.

AU - Franssen, M.T.M.

AU - Sollie, K.M.

AU - Vandenbussche, F.P.H.A.

AU - Woiski, M.

AU - Grobman, W.A.

AU - van der Post, J.A.M.

AU - Bossuyt, P.M.M.

AU - Opmeer, B.C.

PY - 2014

Y1 - 2014

N2 - OBJECTIVE: To estimate the performance of combining cervical length measurement with fetal fibronectin testing in predicting delivery in women with symptoms of preterm labor.METHODS: We conducted a prospective nationwide cohort study in all 10 perinatal centers in The Netherlands. Women with symptoms of preterm labor between 24 and 34 weeks of gestation with intact membranes were included. In all women, qualitative fibronectin testing (0.050-microgram/mL cutoff) and cervical length measurement were performed. Logistic regression was used to predict spontaneous preterm delivery within 7 days after testing. A risk less than 5%, corresponding to the risk for women with a cervical length of at least 25 mm, was considered as low risk.RESULTS: Between December 2009 and August 2012, 714 women were enrolled. Fibronectin results and cervical length were available for 665 women, of whom 80 (12%) delivered within 7 days. Women with a cervical length of at least 30 mm or with a cervical length between 15 and 30 mm with a negative fibronectin result were at low risk (less than 5%) of spontaneous delivery within 7 days. Fibronectin testing in case of a cervical length between 15 and 30 mm additionally classified 103 women (15% of the cohort) as low risk and 36 women (5% of the cohort) as high risk.CONCLUSION: Cervical length measurement, combined with fetal fibronectin testing in case of a cervical length between 15 and 30 mm, improves identification of women with a low risk to deliver spontaneously within 7 days.

AB - OBJECTIVE: To estimate the performance of combining cervical length measurement with fetal fibronectin testing in predicting delivery in women with symptoms of preterm labor.METHODS: We conducted a prospective nationwide cohort study in all 10 perinatal centers in The Netherlands. Women with symptoms of preterm labor between 24 and 34 weeks of gestation with intact membranes were included. In all women, qualitative fibronectin testing (0.050-microgram/mL cutoff) and cervical length measurement were performed. Logistic regression was used to predict spontaneous preterm delivery within 7 days after testing. A risk less than 5%, corresponding to the risk for women with a cervical length of at least 25 mm, was considered as low risk.RESULTS: Between December 2009 and August 2012, 714 women were enrolled. Fibronectin results and cervical length were available for 665 women, of whom 80 (12%) delivered within 7 days. Women with a cervical length of at least 30 mm or with a cervical length between 15 and 30 mm with a negative fibronectin result were at low risk (less than 5%) of spontaneous delivery within 7 days. Fibronectin testing in case of a cervical length between 15 and 30 mm additionally classified 103 women (15% of the cohort) as low risk and 36 women (5% of the cohort) as high risk.CONCLUSION: Cervical length measurement, combined with fetal fibronectin testing in case of a cervical length between 15 and 30 mm, improves identification of women with a low risk to deliver spontaneously within 7 days.

KW - FETAL FIBRONECTIN

KW - DELIVERY

KW - MODELS

KW - BIRTH

KW - WOMEN

KW - METAANALYSIS

KW - NIFEDIPINE

KW - TOCOLYSIS

KW - THERAPY

U2 - 10.1097/AOG.0000000000000229

DO - 10.1097/AOG.0000000000000229

M3 - Article

C2 - 24807328

SN - 0029-7844

VL - 123

SP - 1185

EP - 1192

JO - Obstetrics and Gynecology

JF - Obstetrics and Gynecology

IS - 6

T2 - 33rd Annual Scientific Pregnancy Meeting of the Society-for-Maternal-Fetal-Medicine (SMFM)

Y2 - 11 February 2013 through 16 February 2013

ER -

Predictive Value of Cervical Length Measurement and Fibronectin Testing in Threatened Preterm Labor

Abstract

Keywords

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