[Is fetal fibronectin a valid test predictive of premature labor?]

This study sought to determine the value of oncofetal fibronectin as predictor of preterm delivery in patients presenting with preterm labor. Patients admitted for preterm labor with intact membrane between 24 and 34 weeks gestation were included. A dacron swab applied to the external os for 10 seconds. The fetal fibronectin is detected bill a biologic membrane test. 90 patients were included. 25 (28%) had positive fetal fibronectin, and 13 (52%) had preterm delivery (specificity and positive value 81% and 52% respectively). Among 65 (72%) with negative fetal fibronectin, only 12 (18%) had preterm delivery (sensitivity 81% and negative predictive value 81%: p < 0.001). Median interval between sampling and delivery was 5 days in the positive compared to 23 in the false negative group. The presence of fetal fibronectin in the cervico-vaginal mucus strongly suggest an eminent delivery within few days after sampling. The sensitivity of the test is the 62% and still more interesting the negative predictive value is 86% (p < 0.001). The fetal fibronectin is a useful test to help the obstetrician discriminating true from false labor in patients with high risk preterm delivery. A negative test is very reassuring according to its high negative predictive value. Allowing to avoid unuseful tocolyse and long hospital.