Re: blind ffn article
From: Andrew Folley (agfolley@hotmail.com)
Fri Apr 8 15:35:57 2005
Dan, I think that this study at least suggests that blind sampling gives
similar numbers and a similar negative predictave value to speculum exam.
In other words with a negative FFN (blind or speculum) we see a 99% chance
the pateitn will not deliver in next two weeks. andy
>From: "R. Daniel Braun" <rd.braun@gmail.com>
>Reply-To: ob-gyn-l@obgyn.net
>To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
>Subject: Re: blind ffn article
>Date: Fri, 8 Apr 2005 06:37:02 -0500
>
>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
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