Comparison Of Examination Premature Labor Between Level Of Fetal Fibronectin Plus Length Of Cervix And Evaluate The Relationship Between Infection And Premature Birth

Objective:①To explore the clinical value of fetal fibronectin (fFN) and cervical length (CL) alone and combination for preterm birth in preganant women with preterm labor.②To evaluate the relationship between infection and premature birth.Methods:①Totally,107 pregnant women at 28-34 gestational weeks were enrolled from Jan.2009 to Jan.2011 at the First Affiliateted Hospital of Kunming Medical College, and all subjects with high risk of preterm birth, but without preterm premature rupture of membrane or vaginal bleeding. Cervical fFN was determined and CL was measured by transvaginal ultrasound. The pregnancy outcome was compared.②Endocervical swabs were taken from all the 107 women, pathological result of placental tissues were collected from the 31 women with premature birth, and another 76 women were selected from the same time who has birth. The relationship between infection in pregnant women and premature birth was explored.Results:①The sensitivity, specificity, positive predictive value (PPV) and negative predicitive value (NPV) of fFN in predicting preterm birth within 7 days was 100%,71.7%,22.2% and 100% respectively; 74.2%,82.9%,63.9%,88.7%for deliveries within 37 weeks. The above figures changed to 87.5%,67.7%,17.9%and 98.5%for deliveries within 7 days and 77.4%,88.3%,61.5%,89.7%for those withing 37 weeks, respectively, when cervical length≤3.0cm was applied to predict preterm birth. When fFN and cervical length were combined, the sensitivity, specificity, PPV and NPV was 87.5%,80.8%,26.9%and 98.8% for deliveries within 7 days, and 61.3%,90.8%,73.1%,85.2%for those within 37 weeks, respectively.②In the premature birth group, there were 21 cases at least one of the result chlamydia trachomatis(CT)or ureaplasma urealyticum(UU)or bacterial culture was positive; in the trem labor group, there were 27 cases at least one of the result CTor UU or bacterial culture was positive; and there was significant difference between the two groups.In the premature birth group, there were 26 of the cases which pathological result of placental tissues presentation infection, in the trem labor group, there were 24 of the cases which pathological result of placental tissues presentation infection, and there was significant difference between the two groups.Conclusions:①fFN is valualbe in predicting preterm birth in women with preterm labor, especially significant for NPV.②CL is also important means for predicting the preterm birth, espacially significant for NPV.③And fFN combined with CL can improve the specificity and PPV of preterm delivery less than 37 weeks.④Infection should be significant associated with premature delivery.