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Revista Chilena de Obstetricia y Ginecología
Article . 2008 . Peer-reviewed
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LONGITUD CERVICAL Y FIBRONECTINA EN EL SÍNTOMA DE PARTO PREMATURO

Authors: Treuer P, Carlos; Quiroz G, Víctor; Cabrera D, Jorge; Soto L, Carmen; Araneda C, Heriberto;

LONGITUD CERVICAL Y FIBRONECTINA EN EL SÍNTOMA DE PARTO PREMATURO

Abstract

Antecedentes: En Chile el parto prematuro es la principal causa de morbilidad y mortalidad perinatal. Objetivo: Evaluar la utilidad clínica de la longitud cervical y la detección de fibronectina, en la predicción de parto prematuro. Método: Estudio observacional prospectivo, de corte transversal en 86 pacientes que consultaron por síntomas de parto prematuro (SPP), con membranas indemnes y edad gestacional entre las 22 y 34 semanas. El grupo estudio formado por gestantes con parto prematuro dentro de los 7 días. Al ingreso se tomó muestra cervical para fibronectina y se midió longitud cervical mediante ultrasonografía transvaginal. Resultados: De las 86 gestantes estudiadas, en 13 (15%) se produjo el parto dentro de los 7 días. La curva ROC mostró un área bajo la curva para longitud cervical de 0,475 y sensibilidad 31% (4/13), especificidad 96% (70/73), valor predictivo positivo 57% (4/7) y valor predictivo negativo 89% (70/79), riesgo relativo positivo 5,0 y riesgo relativo negativo 0,47 (p=0,014). El área bajo la curva para fibronectina fue 0,92 con una sensibilidad 77% (10/13), especificidad 90% (66/73), valor predictivo positivo (10/17) 59% y valor predictivo negativo 96% (66/69), riesgo relativo positivo 13,48 y riesgo relativo negativo 0,43 (pBackground: In Chile the preterm labor is the main cause of perinatal morbidity and mortality. Objective: To evalúate the clinical utility of the cervical length and fibronectin determination in predicting preterm delivery. Method: A prospective observational and transactional study was made, in 86 patients with preterm labor symptoms and gestational age between 22 and 34 weeks. The study group included patients with labor and delivery within a week of admission. From each patient a cervico-vaginal specimen was obtained to measure fibronectin and transvaginal ultrasonographic evaluation of the uterine cervix. Results: From 86 patients admitted to the study, thirteen had preterm labor (15%). The ROC curve showed an área under curve for cervical length of 0.475 and sensitivity 31 % (4/13), specificity 96% (70/73), positive predictive valué 57%(4/13), negative predictive valué 88% (70/79), positive relative risk was 5.0, and the negative relative risk 0.47 (p=0.014); for fibronectin was 0.92 and sensitivity 77% (10/13), specificity 90% (66/73), positive predictive valué 59% (10/17), negative predictive valué 96% (66/69), positive relative riskof 13.48, negative relative risk 0.43 (p=0.014). Conclusión: In patients with premature labor symptoms, the cervical lengths none shortened and negative fibronectin result were associated with a low risk of having a preterm labor. Positive fibronectin was a better predictor of premature birth in a week of admission and the cervical length was the best in ruling out the occurrence of a premature birth

Keywords

Preterm labor, Gynecology and obstetrics, cuello uterino, ultrasonografía transvaginal, fibronectina, transvaginal ultrasonography, RG1-991, fetal fibronectin, Parto prematuro, uterine cervix

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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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