Re: blind ffn article
From: R. Daniel Braun (rd.braun@gmail.com)
Fri Apr 8 20:53:44 2005
But we don't know that, They are only comparing their numbers to
other peoples studies. They don't have any controls to use. Other
peoples controls may be a totally diferent population than theirs.
An example: In a former setting(private practice type) I had a 4% post
C/S febrile morbidity rate without prophylactic antibiotics. In
current setting(county Hospital Teaching service), it is closer to 40%
WITH prophylactic antibiotics.
Dan
On Apr 8, 2005 3:37 PM, Andrew Folley <agfolley@hotmail.com> wrote:
> 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
>
--
R. Daniel Braun
Kinky for Governor
