Abstract:
BACKGROUND:The combination of the qualitative fetal fibronectin test and cervical length measurement has a high negative predictive value for preterm birth within 7 days; however, positive prediction is poor. A new bedside quantitative fetal fibronectin test showed potential additional value over the conventional qualitative test, but there is limited evidence on the combination with cervical length measurement. OBJECTIVE:The purpose of this study was to compare quantitative fetal fibronectin and qualitative fetal fibronectin testing in the prediction of spontaneous preterm birth within 7 days in symptomatic women who undergo cervical length measurement. STUDY DESIGN:We performed a European multicenter cohort study in 10 perinatal centers in 5 countries. Women between 24 and 34 weeks of gestation with signs of active labor and intact membranes underwent quantitative fibronectin testing and cervical length measurement. We assessed the risk of preterm birth within 7 days in predefined strata based on fibronectin concentration and cervical length. RESULTS:Of 455 women who were included in the study, 48 women (11%) delivered within 7 days. A combination of cervical length and qualitative fibronectin resulted in the identification of 246 women who were at low risk: 164 women with a cervix between 15 and 30 mm and a negative fibronectin test (<50 ng/mL; preterm birth rate, 2%) and 82 women with a cervix at >30 mm (preterm birth rate, 2%). Use of quantitative fibronectin alone resulted in a predicted risk of preterm birth within 7 days that ranged from 2% in the group with the lowest fibronectin level (<10 ng/mL) to 38% in the group with the highest fibronectin level (>500 ng/mL), with similar accuracy as that of the combination of cervical length and qualitative fibronectin. Combining cervical length and quantitative fibronectin resulted in the identification of an additional 19 women at low risk (preterm birth rate, 5%), using a threshold of 10 ng/mL in women with a cervix at <15 mm, and 6 women at high risk (preterm birth rate, 33%) using a threshold of >500 ng/mL in women with a cervix at >30 mm. CONCLUSION:In women with threatened preterm birth, quantitative fibronectin testing alone performs equal to the combination of cervical length and qualitative fibronectin. Possibly, the combination of quantitative fibronectin testing and cervical length increases this predictive capacity. Cost-effectiveness analysis and the availability of these tests in a local setting should determine the final choice.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Bruijn MM,Kamphuis EI,Hoesli IM,Martinez de Tejada B,Loccufier AR,Kühnert M,Helmer H,Franz M,Porath MM,Oudijk MA,Jacquemyn Y,Schulzke SM,Vetter G,Hoste G,Vis JY,Kok M,Mol BW,van Baaren GJdoi
10.1016/j.ajog.2016.08.012subject
Has Abstractpub_date
2016-12-01 00:00:00pages
793.e1-793.e8issue
6eissn
0002-9378issn
1097-6868pii
S0002-9378(16)30577-4journal_volume
215pub_type
杂志文章abstract:OBJECTIVE:The study's objective was to provide an introduction to the role of corticotropin-releasing hormone in preterm delivery associated with stress. STUDY DESIGN:A selective review of the current literature relevant to the objective was undertaken. Published data were analyzed for relevance to the biochemical mod...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/s0002-9378(99)70713-1
更新日期:1999-01-01 00:00:00
abstract:OBJECTIVE:We sought to evaluate inadequate gestational weight gain and fetal growth among overweight and obese women. STUDY DESIGN:We conducted an analysis of prospective singleton term pregnancies in which 1053 overweight and obese women gained >5 kg (14.4 ± 6.2 kg) or 188 who either lost or gained ≤5 kg (1.1 ± 4.4 k...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2014.02.004
更新日期:2014-08-01 00:00:00
abstract::Certain neurological disorders are particularly liable to occur during pregnancy or may be profoundly influenced by it. Moreover, neurological disorders may influence the management of otherwise uncomplicated obstetric cases. Despite the practical importance of this subject, however, little attention has been devoted ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/0002-9378(78)90902-x
更新日期:1978-10-01 00:00:00
abstract:OBJECTIVE:Our purpose was to examine the indications for performing cesarean sections in current obstetric practice and to define and measure the true contribution of dystocia ("difficult labor") to the overall cesarean section rate. STUDY DESIGN:A prospective audit was done of all cesarean sections performed during 1...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(94)70080-x
更新日期:1994-07-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to examine whether women with one elevated value of the 3-hour glucose tolerance test are at increased risk for adverse perinatal outcomes. STUDY DESIGN:This was a retrospective cohort study of singleton pregnancies that were screened for gestational diabetes mellitus with the u...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2006.01.028
更新日期:2006-05-01 00:00:00
abstract:OBJECTIVE:Fatty acids (FAs) are essential for fetal development. Cellular FA uptake is modulated by fatty acid-binding proteins (FABPs). We hypothesized that hypoxia regulates the expression of FABPs in human trophoblasts. STUDY DESIGN:Primary term human trophoblasts were cultured for 72 hours in either standard (O2 =...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2007.03.066
更新日期:2007-11-01 00:00:00
abstract::The relationship between intermittent partial occlusion of the umbilical circulation and fetal acid base status, brain function, and neuropathologic outcome was assessed in nine control and nine experimental singleton fetal lambs to determine if transient episodes of partial cord occlusion play a role in antenatal bra...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(88)80118-2
更新日期:1988-08-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to evaluate whether the amniotic viral load of mothers with primary cytomegalovirus infection correlate with fetal or neonatal outcomes. STUDY DESIGN:Sixty-eight of 138 pregnant women with primary infection defined by immunoglobulin G seroconversion or the presence of immunoglobulin...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2000.106347
更新日期:2000-08-01 00:00:00
abstract:BACKGROUND:Periconceptional diet quality is commonly suboptimal and sociodemographic disparities in diet quality exist. However, it is unknown whether individual periconceptional diet quality is associated with obstetric outcomes. OBJECTIVE:Our objective was to assess differences in maternal and neonatal outcomes acco...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ajog.2020.01.042
更新日期:2020-07-01 00:00:00
abstract:OBJECTIVE:Our purpose was to describe subsequent pregnancy outcome and long-term maternal prognosis in women with HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets) during the index pregnancy. STUDY DESIGN:This is a descriptive and analytic study of women with HELLP syndrome admitted to E.H. Crump W...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(95)90099-3
更新日期:1995-01-01 00:00:00
abstract::The mechanisms of steroid action remain a poorly understood enigma. Although much effort has focused on the steroid receptor as a mediator of the steroid's effect in the cell, we are only beginning to understand the structure of steroid receptors. Development of monoclonal antibodies directed against both the steroid-...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(87)90015-9
更新日期:1987-06-01 00:00:00
abstract::Swan-Ganz catheterization was performed in 15 postpartum women who presented with severe pregnancy-induced hypertension at a mean gestational age of 31.5 weeks. The mean arterial pressure on presentation was 137.6 torr (range, 116 to 167 torr), and it remained at approximately 115 torr for the next 72 hours. Serial pu...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(84)90750-6
更新日期:1984-03-01 00:00:00
abstract:OBJECTIVES:This study was undertaken to examine the national and regional rates of operative delivery among almost one quarter million births in a single year in the nation's largest healthcare delivery system, using variation as an arbiter of the quality of decision making. STUDY DESIGN:We compared the variation in r...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2007.01.024
更新日期:2007-06-01 00:00:00
abstract::We report a case of uterine cancer and invasive cervical cancer, detected incidentally during the female-to-male sex reassignment surgery. The management of these patients is presented. Such individuals may not be receiving regular gynecologic care appropriate to their remaining genital organs; symptoms of malignant d...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2010.12.057
更新日期:2011-05-01 00:00:00
abstract::Forty pregnant women between 30 and 42 weeks' gestational age were studied to examine the effects of external sound and vibration on the fetal heart rate. A significant increase in the mean duration and amplitude of the first acceleration after sound stimulus was found when these values were compared with the control ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(86)80037-0
更新日期:1986-10-01 00:00:00
abstract::A randomized controlled study was carried out at three medical centers to compare the efficacy and side effects of ethanol and ritodrine in the treatment of threatened premature labor. One hundred and thirty-five patients judged to be between the twentieth and thirty-sixth week of gestation and presenting with clinic...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-9378(77)90115-6
更新日期:1977-04-15 00:00:00
abstract::Theories of intimal injury leading to plaque formation include platelet adhesion and production of growth factors, hypercholesterolemia, smooth muscle cell proliferation, macrophage activity, defective utilization of low-density lipoproteins via deficient receptors, and deficiency in cellular lysosomal enzymes. High l...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/0002-9378(88)90194-9
更新日期:1988-06-01 00:00:00
abstract:OBJECTIVE:The prototype of surgical treatment for vulvar vestibulitis has been the Woodruff vulvoplasty. A simpler surgery could be less morbid, technically easier, and equally effective. STUDY DESIGN:Twelve patients underwent vestibular revision, nine with local anesthesia. They were followed up for between 6 months ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(96)70200-4
更新日期:1996-06-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate factors affecting birth charges in twin pregnancies. STUDY DESIGN:Clinical and financial data were obtained on 1486 twin pregnancies delivered between 1995 to 2002 at medical centers in Maryland, Florida, Michigan, and South Carolina. Maternal and neonatal length of ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2004.05.057
更新日期:2005-03-01 00:00:00
abstract::This study was undertaken to determine the effect of choice of birth route on infant outcome in fetal breech presentation. The study group excluded infants who were footling breeches and infants with major congenital anomalies. The mothers were in labor with the fetal heartbeat present at entry into the labor room. Ou...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(84)90533-7
更新日期:1984-04-01 00:00:00
abstract:OBJECTIVE:Fetal alcohol syndrome (FAS) is associated with intellectual disability and neurodevelopmental abnormalities. Neuroprotective peptides NAPVSIPQ (NAP) and SALLRSIPA (SAL) can prevent some of the alcohol-induced teratogenesis including fetal death, growth abnormalities, and learning impairment in part by preven...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2012.10.005
更新日期:2012-12-01 00:00:00
abstract::A severely Rh-isoimmunized pregnancy is described in which an intrauterine transfusion of blood was given by the intravascular route directly into an umbilical vessel. Fetoscopy was not used, and the procedure was performed percutaneously under direct ultrasound visualization. ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(86)90613-7
更新日期:1986-03-01 00:00:00
abstract::The effect of actinomycin D on estrogen-induced uterine blood flow was studied in four nonpregnant, oophorectomized sheep, utilizing electromagnetic flow probes chronically implanted around the uterine arteris. Two hours after the intravenous injection of 1 mug of estradiol-17beta per kilogram of body weight, incorpor...
journal_title:American journal of obstetrics and gynecology
pub_type: 历史文章,杂志文章
doi:10.1016/0002-9378(75)90166-0
更新日期:1975-06-01 00:00:00
abstract:OBJECTIVE:The purpose of this report is to bring to the attention of obstetric care providers the occurrence in pregnancy of a threatening pulmonary syndrome caused by hantavirus infection. STUDY DESIGN:Two recent cases of hantavirus pneumonitis in pregnancy, one complicated by adult respiratory distress syndrome, are...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(94)90298-4
更新日期:1994-08-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to assess the use-effectiveness of oral contraceptives (OCs) in Europe according to body mass index (BMI), weight, age, and other factors. STUDY DESIGN:In a planned secondary analysis, we used data from the European Active Surveillance Study on Oral Contraceptives, which was a p...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2009.03.017
更新日期:2009-09-01 00:00:00
abstract::Epithelial inclusion cysts may be a late complication of traditional female genital surgery. We present the case of a 19-year-old Eritrean woman who had been circumcised at birth and sought treatment for an enlarging vulvar mass that arose after the onset of puberty. Symptoms included pain, pruritus, and interference ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2000.105963
更新日期:2000-08-01 00:00:00
abstract:OBJECTIVE:The effect of maternal tryptophan loading on fetal plasma and brain, kynurenic acid, and quinolinic acid concentrations was compared in late gestation fetal sheep with either chronically embolized or nonembolized placentas. STUDY DESIGN:The placentas of 4 ewes were embolized by daily injection of mucopolysac...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2001.117969
更新日期:2001-10-01 00:00:00
abstract:OBJECTIVE:Our goal was to use population-based data to determine the difference in 5-year survival in women diagnosed with cervical cancer between those aged 18-34 years and those aged 40-60 years. STUDY DESIGN:The SEER (Surveillance, Epidemiology, and End Results) public-use database, 1973-1994, was used for this inv...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(99)70038-4
更新日期:1999-06-01 00:00:00
abstract:OBJECTIVE:The objective of the study was to examine the effect of first-trimester obstetric ultrasound (OBUS) on the measurement of the effect of complications ascribed to postterm pregnancies. STUDY DESIGN:We conducted a retrospective cohort study of all term, singleton pregnancies delivered at our institution who ha...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2008.03.034
更新日期:2008-06-01 00:00:00
abstract:OBJECTIVE:My purpose was to explore the criteria of The American College of Obstetricians and Gynecologists (Technical Bulletin No. 163) for perinatal asphyxia to be linked to subsequent cerebral palsy. STUDY DESIGN:Analysis of four cases of intrapartum fetal insults with subsequent cerebral palsy and a literature rev...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/0002-9378(95)91419-6
更新日期:1995-06-01 00:00:00