Fetal Fibronectin in cervical and vaginal secretions as a predictor of preterm delivery

To evaluate the detection of fetal fibronection in cervico-vaginal secretions of patients with symptoms suggestive of preterm labour, as a predictor of preterm birth, 235 women presenting to the delivery suite between 24 to 37 weeks of gestation were selected. Speciemens of cervico-vaginal secretions were collected and fetal fibronectin levels were measured by >/= ELISA. Samples were considered positive if the level was >/= 005 ug/ml. It was found that fetal fibronection predicted preterm labour with positive predictive value of 80.76%, negative predictive value of 89.61%, sensitivity of 68.85% and specificity of 94.25%. Analysis of the data from women at less than 34 weeks of gestation showed similar results. Of the negative fetal fibronectin results obtained upon admission, 96.75% of women delivered after 7 days. It was concluded that fetal fibronectin appears as a promising marker for predicting preterm delivery in high risk women. However, only when we fully understand how the mechanisms underlying the release and their initiation are related to the processes leading to labour, will the full potential of the test be realized

Randomised Trial of Endometrial Laser Ablation [ELA], Transcervical Resection of the Endometrium [TCRE], and Thermal Balloon Ablation [TBA] for the treatment of menorrhagia

A randomised controlled trial was set up to compare the safety and clinical efficacy of endometrial ablation in the treatment of menorrhagia, performed either with ELA, TCRE or TBA. A total of 120 women with menorrhagia were selected and randomly allocated to ELA [GI], TCRE [GII] or TBA [GIII]. The main outcome measures were operative complications, post-operative recovery, relief of, menstrual and other symptoms, need for further surgical treatment, satisfaction with treatment at 6 and 12 months, postoperatively. It was found that the operating and theatre times were significantly shorter in TBA, than ELA or TCRE. However, there was no significant difference between the three groups as regard the complication rates, concomitant surgery, morbidity and duration of hospital stay. Also, it was found that there was significant improvement in bleeding and pain scores dysmenorrhoea and premenstrual symptoms at 6 and 12 months, in each group. Overall satisfaction levels were high. It was concluded that endometrial ablation is a reliable, safe alternative to hysterectomy for the treatment of monorrhagia. TBA is a safe and effective option. The procedure is simple, allowing the learing curve to be almost negligible