New Test Eyed for Ruling Out Preterm Delivery
From the Annual Meeting of the Society of Obstetricians and Gynaecologists of Canada
The ph IGFBP-1 test and the fetal fibronectin test had similarly good negative predictive values for preterm delivery (0.86 and 0.88).
The positive predictive value was poor for both, although somewhat more so for ph IGFBP-1 (0.22 and 0.54).
The ph IGFBP-1 test and the fetal fibronectin test also both had poor sensitivity (39% and 33%), while specificity was marginally poorer for the former test (74% and 95%).
The investigators also assessed the performance of the two tests combined. “There were times when they agreed and times when they didn't agree, but it didn't seem to be that combining them together improved your predictability,” she said.
Recent data suggest that predictability may improve when a biochemical marker is combined with cervical length on ultrasound, noted Dr. Cooper.
“The problem is, we are looking for a rapid bedside test for people in rural areas who don't have resources,” she commented. “So if we start putting cervical length into the mix, then it takes away the primary objective of how do we help people who are living in rural areas that are rural enough to have to make decisions about clinical transfer.”
