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Fetal fibronectin in symptomatic twin gestations
1Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Mississippi, Jackson, USA
Primary Care Update for Ob/Gyns
|June 6, 2000
Summary
The fetal fibronectin (fFN) assay can help predict preterm labor in twin gestations. A negative fFN result provides reassurance against imminent delivery, aiding conservative treatment strategies.
Area of Science:
- Perinatology
- Maternal-Fetal Medicine
- Diagnostic Assays
Background:
- Preterm labor (PTL) in twin gestations presents unique clinical challenges.
- Accurate prediction of imminent delivery is crucial for effective management.
- The fetal fibronectin (fFN) assay is a biomarker used to assess PTL risk.
Purpose of the Study:
- To evaluate the diagnostic performance of the fetal fibronectin (fFN) assay in twin gestations symptomatic for preterm labor.
- To determine the predictive value of a negative fFN assay in this high-risk population.
Main Methods:
- Prospective analysis of 955 symptomatic patients from two multicenter trials.
- Focus on 43 patients with twin gestations experiencing PTL with intact membranes (24-35 weeks).
- fFN assay results were correlated with delivery within 7 days of symptom onset.
Main Results:
- The sensitivity of the fFN assay was 75% and the positive predictive value was 54.5% (11/43 positive, 6 delivered within 7 days).
- The specificity was 85.7% and the negative predictive value was 93.7% (32/43 negative, 2 delivered within 7 days).
- Positive predictive value in twins (54%) is higher than in singletons (12.7%).
Conclusions:
- The negative predictive value of the fFN assay in twin gestations (93.7%) is comparable to singletons (99.5%).
- A negative fFN assay can reassure clinicians and patients regarding the likelihood of delivery within 7 days.
- This may support more conservative management of PTL in twins, potentially reducing treatment-related morbidity.