Re: blind ffn article
From: R. Daniel Braun (rd.braun@gmail.com)
Fri Apr 8 06:35:39 2005
Not very helpful as it doesn't compare blind sampling to visual
sampling. It appears to say that blind sampling may be better than NO
sampling.
Dan
On Apr 7, 2005 7:43 PM, RModugno@aol.com <RModugno@aol.com> wrote:
> Obstetrics & Gynecology 2005;105:285-289
> (c) 2005 by The American College of Obstetricians and Gynecologists
>
> ________________________________
>
> ________________________________
> ORIGINAL RESEARCH
>
> "Blind" Vaginal Fetal Fibronectin as a Predictor of Spontaneous Preterm
> Delivery Ashley S. Roman, MD, MPH*, Nikki Koklanaris, MD*, Michael J.
> Paidas, MD, Jeanine Mulholland, RN*, Mortimer Levitz, PhD* and Andrei
> Rebarber, MD*
>
> From the *Department of Obstetrics and Gynecology, New York University
> School of Medicine, New York, New York; and Department of Obstetrics and
> Gynecology, Yale University School of Medicine, New Haven, Connecticut.
>
> Address reprint requests to: Ashley S. Roman, MD, MPH, 550 First Avenue, NB
> 9E2, New York, NY 10016; e-mail: achapinsmith@aol.com .
>
> OBJECTIVE: To assess the accuracy of vaginal fetal fibronectin sampling
> without use of a sterile speculum examination as a screening test for
> predicting spontaneous preterm birth.
>
> METHODS: A historical cohort of patients who were followed up with serial
> fetal fibronectin testing between 1998 and 2001 was identified. All patients
> were considered to be at high risk for preterm delivery and were screened
> with fetal fibronectin testing without using a speculum at 2- to 3-week
> intervals from 22 weeks to 32 weeks of gestation. Charts were reviewed for
> fetal fibronectin results and pregnancy outcome data. Groups were compared
> using 2 analysis or Fisher exact test with significance defined as P < .05.
>
> RESULTS: A total of 1,396 fetal fibronectin tests from 416 pregnancies were
> performed via the "blind" sampling technique. Overall, 24.9% of pregnancies
> delivered spontaneously before 37 weeks; 9.1% delivered spontaneously before
> 34 weeks. For delivery before 34 weeks of gestation, the test had a
> sensitivity of 44.7%, a specificity of 88.4%, a positive predictive value of
> 27.9%, and a negative predictive value of 94.1%. For delivery within 14 and
> 21 days of a single fetal fibronectin assessment, the test had a sensitivity
> of 52% and 45.5%, a specificity of 94.5% and 94.9%, a positive predictive
> value of 14.6% and 22.5%, and a negative predictive value of 99.1% and
> 98.2%, respectively.
>
> CONCLUSION: "Blind" vaginal fetal fibronectin sampling has high negative
> predictive values and specificities in predicting spontaneous preterm birth.
>
> LEVEL OF EVIDENCE: II-2
>
--
R. Daniel Braun
Kinky for Governor
