Background Fetal fibronectin (fFN) is an excellent predictor of preterm birth (PTB). However its use in primiparous women is limited, including those with previous cervical surgery, who are at increased risk of PTB.
Methods The authors evaluated the use of fFN in all women referred to a Preterm Clinic over 12 months, comparing primiparous women with cervical surgery, to those tested for previous preterm delivery. 30 primiparous women with either a LLETZ or Cone biopsy and 306 with a previous delivery between 16 and 37 weeks were compared. χ2 or Fisher's exact test were used to compare proportions as appropriate.
Results Table shows similar proportion of women with a +ve test, and similar outcome in both groups. (NS using χ2)
False negative rates for delivery <34/40 were 9% (22/243) in the previous PTB group, compared to 0/22 for the primip group.
Conclusions fFN can be used to screen for PTB risk in women with previous cervical surgery. Positive rates have similar prediction to screening high risk women based on previous early delivery. Negative prediction may be better in primiparous women than those with a previous adverse event.
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