Fetal fibronectin membrane immunoassay in the detection of premature rupture of membranes and prediction of preterm labour

ABSTRACT

The objective of this study was to evaluate the sensitivity of fetal fibronectin membrane immunoassay in the detection of premature rupture of membranes and prediction of preterm labour. Seventy-two woman were evaluated using ROM-Check immunoassay, which utilizes a monoclonal antibody to the fetal fibronectin in the amniotic fluid drained into the vagina of 13 patients with unequivocal preterm premature rupture of membranes and in 35 patients with a previous history or features of preterm labour. Sensitivity of the fetal fibronectin immunoassay was 90.5% and the specificity was 61.0% in the detection of preterm spontaneous rupture of membranes. The positive and negative predictive values were 54.3 and 92.6%, respectively. In the patients with a previous history of preterm labour, 92% of those with positive fibronectin immunoassay had preterm delivery within 7 days of sampling; this contrasts with 87% of those with negative fibronectin immunoassay who delivered at term, defined as >/= 37 weeks of gestation, or close to term, with much better perinatal outcome [p <0.01]. In conclusion, fetal fibronectin immunoassay is a good method of detecting ruptured membranes and a strong predictor of spontaneous preterm labour