Abstract
Objective: The purpose of this study was to evaluate a strategy for the identification of patients
with multiple gestations who are at low risk for preterm delivery. Study Design: A prospective observational study among patients with twin and triplet gestations.
At 20 and 24 weeks of gestation, screening for bacterial vaginosis and fetal fibronectin
was performed, followed by digital and sonographic assessment of the cervix. The treating
physicians were blinded to test results. Results: At the 24-week examination, specificities for delivery at >32 weeks of gestation
for digital examination (92.9%), fetal fibronectin level (93.9%), cervical length
on sonographic scan (85.1%), and combined fetal fibronectin level and cervical length
(81.3%) did not differ statistically. Negative predictive values for these tests were
≥95%. All tests performed better at 24 weeks of gestation than at 20 weeks of gestation.
Conclusion: At 24 weeks of gestation, a normal digital examination, a negative fetal fibronectin
level, a normal cervical length on sonographic scan, or the combination of a negative
fetal fibronectin level and a normal cervical length each confer a similarly high
likelihood of delivery at >32 weeks of gestation in women with multiple gestations.
(Am J Obstet Gynecol 2002;186:1137-41.)
Keywords
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Article Info
Footnotes
☆Reprint requests: Mark G. Neerhof, DO, 2650 Ridge Ave, Evanston, IL 60201.
Identification
Copyright
© 2002 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
