Abstract:
:Preterm birth is a major complication of pregnancy and remains a leading cause of neonatal morbidity and mortality worldwide. Improvements in the authors' understanding of the pathophysiology of preterm labor have led to the development of novel diagnostic tools of use to identify women at greatest risk for preterm birth. Currently two FDA-approved biochemical tests are available in the United States: (1) fetal fibronectin and (2) salivary estriol. The presence of a positive fetal fibronectin test in the midtrimester of pregnancy is strongly associated with early spontaneous preterm birth. In contrast, a positive salivary estriol test is associated with late preterm birth, thus limiting its clinical use. Both tests have low test sensitivity and are currently used clinically for their negative predictive values. That is, women who screen negative are at very low risk for preterm birth and, thus, no interventions are indicated to prevent preterm birth. Women with a positive test are at increased risk and would be candidates for intervention. One of the main limitations of fetal fibronectin and salivary estriol, and an array of other proposed markers, is the fact that while these markers may aid in identification of women at increased risk for preterm birth, the authors currently have no clearly effective obstetric interventions for preterm-birth prevention in these high-risk women. Use of tocolytics, antimicrobials, or progesterone therapy currently has limited or unproven benefit in the management of women deemed at increased risk using these markers. Thus, until effective targeted obstetric interventions are available, the use of biochemical markers to identify women at increase risk for preterm birth remains largely research tools.
journal_name
Clin Perinatoljournal_title
Clinics in perinatologyauthors
Ramsey PS,Andrews WWdoi
10.1016/s0095-5108(03)00109-xsubject
Has Abstractpub_date
2003-12-01 00:00:00pages
701-33issue
4eissn
0095-5108issn
1557-9840pii
S0095-5108(03)00109-Xjournal_volume
30pub_type
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journal_title:Clinics in perinatology
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journal_title:Clinics in perinatology
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journal_title:Clinics in perinatology
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journal_title:Clinics in perinatology
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journal_title:Clinics in perinatology
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journal_title:Clinics in perinatology
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journal_title:Clinics in perinatology
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journal_title:Clinics in perinatology
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journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
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journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
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journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
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journal_title:Clinics in perinatology
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journal_title:Clinics in perinatology
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journal_title:Clinics in perinatology
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journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
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journal_title:Clinics in perinatology
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journal_title:Clinics in perinatology
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journal_title:Clinics in perinatology
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journal_title:Clinics in perinatology
pub_type: 杂志文章,评审
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journal_title:Clinics in perinatology
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