Objective:

It can be hard for clinicians to diagnose preterm labour in women who apply for threatened preterm labour. The aim of this study is to determine the value of sonographic measurement of cervical length and fetal fibronectin test(FFN) in prediction of preterm delivery within 7 and 14 days of admission to hospital.

Design:

Prospective blinded study.

Settings:

Etlik Zübeyde Hanım Women’s Hospital Ankara

Patients:

We examined 67 singleton pregnancies presenting at 26-36 weeks of gestation with intact membranes and threatened labour.

Interventions:

On admission to the hospital fetal fibronectin(FFN) positivity in cervicovaginal secretions was determined and translabial sonographic measurement of cervical length was carried out.

Main outcome measures:

Delivery within 7and 14 days of presentation.

Results:

Among the 67 women included, 5(7.4%) delivered in 7 days and 11(16.4%) delivered in 14 days.The values of fetal fibronectin test for assesments of deliveries within 7 days and within 14 days were follows; sensitivity: 20%, 54.5%; spesificity: 88.7%, 96.4%; positive predictive value(PPV): 12.5%, 75% and negative predictive value(NNV): 93.2%, 91.5% consecutively. The values of the cervical length measurement with a 30mm cut off point which was calculated in ROC analysis were follows for the deliveries within 7 days and within 14 days; sensitivity: 80%, 72.7%; spesificity: 82.3%, 87.5%; PPV: 26.7%, 53.3% and NPV: 98.1%, 94.2% consecutively. When both tests were taken together only the values for prediction of deliveries within 14 days were increased

Conclusions:

The sonographic measurement of cervical length is more valuable for prediction of true preterm labour than fetal fibronectin itself. The prediction of the likelihood of delivery within7 days provided by cervical length is not improved by the addition of fetal fibronectin testing but it is improved for deliveries within 14 days

Keywords: Cervical Length Measurement, Fetal fibronectin, preterm labour