Qualitative cervicovaginal fluid β‑hCG versus cervicovaginal fluid fetal fibronectin assessment in prediction of preterm labor in asymptomatic high risk women
Context: Preterm births occur in 11% of all births worldwide, but account for more than 85% of perinatal morbidity and mortality. One of the best predictors to assess the risk of preterm labor (PTL) is by measuring fetal fibronectin (fFN) in cervicovaginal secretions (CVS). In addition, measurement of cervicovaginal fluid fFN is a good negative predictor of spontaneous PTL in both symptomatic and asymptomatic high‑risk women after 22 weeks of pregnancy.
Aim: We aimed to evaluate the diagnostic accuracy of qualitative cervicovaginal beta‑human chorionic gonadotropin (β‑hCG) versus qualitative fFN for prediction of PTL in asymptomatic high‑risk women during antenatal care.
Settings and Design: This prospective observational study was undertaken at Egypt, Zagazig University Hospitals. In all, 220 with singleton pregnancies and having risk factors for spontaneous preterm birth were included in this study.
Materials and Methods: Cervicovaginal fluid sampling was undertaken at 24 weeks gestational age for qualitative β‑hCG and qualitative fFN assessment. Women were categorized into two arms: women who delivered preterm and women who delivered at term.
Statistical Analysis Used: Data were presented as mean, ±standard deviation, number, and percentage. Chi‑square test (χ2) was used for comparison between groups with regard to qualitative variables; validity of the test is done using sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).
Results: As regarding qualitative β‑hCG assessment for prediction of PTL, sensitivity, specificity, PPV, and NPV were 72%, 85%, 41%, and 95.5%, respectively. As regarding qualitative fFN assessment for prediction of PTL in the same studied group, sensitivity, specificity, PPV, and NPV were 73%, 87%, 38%, and 96%, respectively.
Conclusion: Our study showed that qualitative β‑hCG assessment in cervicovaginal fluid can be used as an alternative method to qualitative fFN assessment as it is a valid test, more available, and not expensive in prediction of PTL in asymptomatic high‑risk patients.
Keywords: β‑hCG; fetal fibronectin; preterm labor
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