Navegando por Palavras-chave "Fetal fibronectin"

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    Avaliação do Risco de Parto Prematuro: Teste da Fibronectina Fetal e Medida do Colo Uterino
    (Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2000-12-01) Oliveira, Tenilson Amaral [UNIFESP]; Carvalho, Carla Muniz Pinto de [UNIFESP]; Souza, Eduardo de [UNIFESP]; Santos, Jorge Francisco Kuhn dos [UNIFESP]; Guaré, Sandra de Oliveira [UNIFESP]; Mariani-Neto, Corintio; Camano, Luiz [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Hospital Maternidade Leonor Mendes de Barros
    Purpose: to evaluate the risk of preterm delivery using the fetal fibronectin test and the measurement of the cervix by transvaginal ultrasonography in pregnant women with previous preterm delivery. Methods: one hundred and seven women were enrolled in the study at 24th, 28thand 32ndweek to detect the presence of fetal fibronectin by immediate-reading membrane test and to perform vaginal ultrasonography to measure the length of the cervix between the internal and external cervical os. The cervix was considered to be short when the cervical length was at or below the cutoff set by the receiver-operating characteristic (ROC) curve for prediction of preterm delivery. Sonographic cervical length and fetal fibronectin were compared to assess the risk of preterm birth before 34 and 37 weeks. Results: the spontaneous preterm delivery rate was 37.4% (40/107). The analysis made by the ROC curve indicated 30 mm as the best cutoff to maximize sensitivity and specificity at 24 and 28 weeks and 25 mm at 32 weeks of gestation. The positive test of fetal fibronectin had a significant relative risk (RR: 1.77; 95% confidence interval (IC): 1.10-2.84) to predict delivery before 37 weeks, when compared with a negative test, only at 28 weeks. The presence of short cervix at 24, 28 and 32 weeks showed a significative RR for birth before 37 weeks. The highest RR occurred with a short cervix at 24 weeks (RR: 4.42; 95% CI: 1.25-15.56). Conclusion: we concluded that the measurement of uterine cervix by vaginal ultrasonography is better than the fetal fibronectin test for evaluating the risk of preterm delivery in women with previous preterm delivery.
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    Detection of fetal fibronectin in twin pregnancies in relation to gestational age
    (Associação Paulista de Medicina - APM, 1999-05-06) Oliveira, Tenilson Amaral [UNIFESP]; Carvalho, Carla Muniz Pinto de; Souza, Eduardo de [UNIFESP]; Mariani-Neto, Corintio; Camano, Luiz [UNIFESP]; Hospital Maternidade Leonor Mendes de Barros; Universidade Federal de São Paulo (UNIFESP)
    CONTEXT: The presence of fetal fibronectin in the cervix or vagina has been investigated as a possible marker for the risk of preterm birth. Fetal fibronectin in cervical fluid can provide direct evidence of pathologic changes at the interface of fetal and maternal tissues. OBJECTIVE: To evaluate the presence of fetal fibronectin as a predictor of premature delivery in twin pregnancies in relation to gestational age. DESIGN: Acuracy study. SETTING: University referral unit. PARTICIPANTS: 52 pregnant women with twin pregnancies and gestational age of between 24 and 34 weeks. MAIN MEASUREMENTS: Sensivity, specifity, predictive values and relative risk ratios of the correlation between fetal fibronectin and preterm birth before 34 and 37 weeks using an immediate-reading membrane test on cervicovaginal secretions obtained from participants. RESULT: The sensitivity varied between 66.7% and 85.7%, whereas the specificity was from 58.3% to 81.8% according to gestational age at the time of sampling. The relative risk of spontaneous preterm birth after a positive fetal fibronectin test, as compared with a negative fetal fibronectin test, rose from 2.8 at 24-26 weeks to 4.1 at 27-30 weeks. Analyses of the risk of delivery before 34 weeks were not statistically significant. CONCLUSION: Fetal fibronectin in the cervicovaginal secretions of patients with twin pregnancies is a useful tool for the early identification of twin pregnancies likely to deliver before 37 weeks. However, the clinical value of the fibronectin test is limited because of low indices for prediction of delivery before 34 weeks. The best period for performing the fetal fibronectin test in twin pregnancies to predict preterm delivery is between 27 and 30 weeks.