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目的:研究胎儿纤维连接蛋白(fFN)对宫颈环扎术后早产的预测价值。方法:选择31例诊断为宫颈机能不全需行宫颈环扎术的住院保胎孕妇,取阴道后穹窿分泌物应用Rapid fFN TLiIQ System进行检测,追踪2周内和34周内分娩的情况。结果:31例患者中,2周内分娩2例,fFN阳性预测宫颈环扎术后孕妇2周内发生早产的敏感性、特异性、阳性预测值、阴性预测值分别为100.0%、69.0%、18.2%、100.0%。34周内分娩6例,fFN阳性预测宫颈环扎术后孕妇34周内发生早产的敏感性、特异性、阳性预测值、阴性预测值分别为66.7%、72.0%、36.4%、90.0%。早产6例占全部分娩孕妇的19.4%,均为34周内分娩,其中2例孕周<28周;剖宫产7例,阴道分娩22例,新生儿均转NICU观察,全部存活,均已出院。结论:宫颈环扎术后行fFN检测可预测早产,其阴性预测价值较高,阳性预测价值低,fFN检测阳性者需结合患者临床表现。
Objective: To investigate the predictive value of fetal fibronectin (fFN) for preterm labor after cervical cerclage. Methods: 31 pregnant women with cervical miscarriage who underwent cervical cerclage diagnosed as cervical incompetence were selected. The vaginal vault secretions were detected by Rapid fFN TLiIQ System, and the situation of childbirth within 2 weeks and 34 weeks was observed. Results: The sensitivity, specificity, positive predictive value and negative predictive value were 100.0%, 69.0%, respectively. The positive predictive value of fFN positive predictive value of preterm delivery within 2 weeks after cervical cerclage in 31 patients was 2 weeks. 18.2%, 100.0%. Six cases were delivered within 34 weeks. The sensitivity, specificity, positive predictive value and negative predictive value of fFN positive predictive value of preterm birth within 34 weeks after cervical cerclage were 66.7%, 72.0%, 36.4% and 90.0% respectively. Premature delivery of 6 cases accounted for 19.4% of all delivery of pregnant women, were delivered within 34 weeks, 2 cases of gestational weeks <28 weeks; cesarean section in 7 cases, 22 cases of vaginal delivery, neonatal NICU were observed, all survived, have Discharged. Conclusion: Fetal cerclage can be used to predict preterm labor after cervical cerclage. The negative predictive value is high, the positive predictive value is low, and the positive fFN test should be combined with the clinical manifestations.