Skip to main content

Advertisement

SpringerLink
Log in

Fetal fibronectin (Quick Check fFN test®) for detection of premature rupture of fetal membranes

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

This article was retracted on 27 December 2023

This article has been updated

Abstract

Objectives

This study was designed to detect the accuracy of the fetal fibronectin (Quick Check fFN test®) in diagnosing premature rupture of fetal membranes.

Study design

This comparative prospective study was carried out over 1 year in Ahmadi Kuwait Oil Company (KOC) Hospital, Kuwait from March 2011 till March 2012.

Patients and methods

Two hundred and twenty (220) pregnant women >34 and <37 weeks gestation were included in this study and divided into two groups according to presence or absence of PROM; 110 patients with PROM were included in group I, and 110 patients without PROM were included in group II as controls. Patients with multiple pregnancies or >37 weeks gestation or not sure of dates or fetal distress or vaginal bleeding or preterm labor or chorioamnionitis were excluded from this study. The diagnosis of PROM was based on patient’s history of sudden gush of water, pooling of amniotic fluid, positive ferning pattern, positive nitrazine test, confirmed by visualization of fluid passing from the cervical canal during sterile speculum examination and Trans-abdominal ultrasound to measure the amniotic fluid index (AFI ≤ 5 cm in PROM). The gestational age was calculate from the first day of LMP and confirmed by early ultrasound scan (done before 20 weeks gestation). Patients included in this study were subjected to standard examination, trans-abdominal ultrasound and sterile speculum examination to detect amniotic fluid pooling through the cervical canal and for collection of samples on admission. Some laboratory investigations were done to exclude chorioamnionitis (maternal fever, maternal tachycardia, fetal tachycardia, maternal leucocytosis, CRP).

Results

In this study, the sensitivity and the specificity of fetal fibronectin in diagnosing PROM were 94.5 and 89.1 %, respectively, as compared with 84.5 % sensitivity and 78.2 % specificity for Ferning test, respectively, and 87.3 % sensitivity and 80.9 % specificity for Nitrazine test, respectively. The PPV and NPV of fetal fibronectin were 89.7 and 94.2 %, respectively, as compared with 79.5 % PPV and 83.5 % NPV for Ferning test, respectively, and 82.1 % PPV and 86.4 % NPV for Nitrazine test, respectively. Fetal fibronectin was more accurate (91.8 %) for detection of PROM than Ferning (81.4 %) or Nitrazine (84.1 %) tests.

Conclusion

The Quick Check fFN test® for detection of the fetal fibronectin in the vaginal fluid is a simple bedside test, more sensitive, and specific than Ferning and Nitrazine tests, it can be used as complimentary test to confirm the clinical diagnosis of premature rupture of fetal membranes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Change history

Abbreviations

CRP:

C-reactive protein

IUGR:

Intrauterine growth retardation

KOC:

Kuwait Oil Company

NPV:

Negative predictive value

PPROM:

Preterm premature rupture of membranes

PPV:

Positive predictive value

PROM:

Premature rupture of membranes

TLC:

Total leucocyte count

References

  1. Medina TM, Hill DA (2006) The Florida Hospital Family Practice Residency Program, Orlando that begins: (Preterm premature rupture of membranes). Am Fam Phys 73:659–664

    Google Scholar 

  2. Furman B, Shoham-Vardi I, Bashiri A, Erez O, Mazor M (2000) Clinical significance and outcome of preterm prelabor rupture of membranes: population-based study. Eur J Obstet Gynecol Reprod Biol 92:209–216

    Article  CAS  PubMed  Google Scholar 

  3. Mercer BM, Goldenberg RL, Meis PJ, Moawad AH, Shellhaas C, Das A, Menard MK, Caritis SN, Thurnau GR, Dombrowski MP, Miodovnik M, Roberts JM, McNellis D (2000) The preterm prediction study: prediction of preterm premature ruptures of membranes through clinical findings and ancillary testing. The National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Am J Obstet Gynecol 183(3):738–745

    Article  CAS  PubMed  Google Scholar 

  4. Dilbaz B, Çaliskan E, Dilbaz S et al (2006) Use of insulin like growth factor binding protein-1 for diagnosis of ruptured fetal membranes in women with preterm labor. J Turk Ger Gynecol Assoc 7(4):325–329

    Google Scholar 

  5. Garite TJ (2001) Management of premature rupture of membranes. Clin Perinatol 28:837–847

    Article  CAS  PubMed  Google Scholar 

  6. Abdelazim IA, Makhlouf HH (2012) Placental alpha microglobulin-1 (AmniSure® test) for detection of premature rupture of fetal membranes. Arch Gynecol Obstet 285:985–989

    Article  PubMed  Google Scholar 

  7. Jeurgens-Borst AJ, Bekkers RL, Sporken JM, van der Berg PP (2002) Use of insulin like growth factor binding protein-1 in the diagnosis of ruptured fetal membranes. Eur J Obstet Gynecol Reprod Biol 102:11–14

    Article  CAS  PubMed  Google Scholar 

  8. Buyukbayrak EE, Turan C, Unal O, Dansuk R, Cengizoglu B (2004) Diagnostic power of the vaginal washing-fluid prolactin assay as an alternative method for the diagnosis of premature rupture of membranes. J Matern Fetal Neonatal Med 15:120–125

    Article  CAS  PubMed  Google Scholar 

  9. Caughey AB, Robinson JN, Norwitz ER (2008) Contemporary diagnosis and management of preterm premature rupture of membranes. Rev Obstet Gynecol 1(1):11–22

    PubMed  PubMed Central  Google Scholar 

  10. Kim YH, Park YW, Kwon HS, Kwon JY, Kim BJ (2005) Vaginal fluid beta human chorionic gonadotropin in level in the diagnosis of premature rupture of membranes. Acta Obstet Gynecol Scand 84:802–805

    PubMed  Google Scholar 

  11. Cooper AL, Stephen T, Vermillion M, David E (2004) Qualitative human chorionic gonadotropin testing of cervicovaginal washings for the detection of preterm premature rupture of membranes. Am J Obstet Gynecol 191:593–597

    Article  CAS  PubMed  Google Scholar 

  12. Esim E, Turan C, Uanl O, Dansuk R, Cengizglu B (2003) Diagnosis of premature rupture of membranes by identification of beta-HCG in vaginal washing fluid. Eur J Obstet Gynecol Reprod Biol 107:37–40

    Article  CAS  PubMed  Google Scholar 

  13. El-Messidi A, Cameron A (2010) Diagnosis of premature rupture of membranes: inspiration from the past and insights for the future. J Obstet Gynaecol Can 32(6):561–569

    Article  PubMed  Google Scholar 

  14. Di Renzo GC, Roura LC, Facchinetti F, Antsaklis A, Breborowicz G, Gratacos E, Husslein P, Lamont R, Mikhailov A, Montenegro N, Radunovic N, Robson M, Robson SC, Sen C, Shennan A, Stamatian F, Ville Y (2011) Guidelines for the management of spontaneous preterm labor: identification of spontaneous preterm labor, diagnosis of preterm premature rupture of membranes and preventive tools for preterm birth. J Matern Fetal Neonatal Med 24(5):659–667

    Article  PubMed  PubMed Central  Google Scholar 

  15. García Alonso LA et al (2002) Utilidad clínica de la expresión de fibronectina fetal (FNF) en secreción cervicovaginal (SCV). Ginecol Obstet Mex 70(8):379–384 [Article in French]

    PubMed  Google Scholar 

  16. Skoll A, St. Louis P, Amiri N, Delisle M-F, Lalji S (2005) The evaluation of the fetal fibronectin test for prediction of preterm delivery in symptomatic patients. JOGC 28:206–213

    Google Scholar 

  17. Schmitz T, Maillard F, Bessard-Bacquaert S, Kayem G, Fulla Y, Cabrol D, Goffinet F (2006) Selective use of fetal fibronectin detection after cervical length measurement to predict spontaneous preterm delivery in women with preterm labor. Am J Obstet Gynecol 194(1):138–143

    Article  CAS  PubMed  Google Scholar 

  18. Gronowski AM, Grenache DG, Markenson G, Weiner R, Demers LM, St Louis P (2007) Reproductive testing. In: Nichols JH (ed) The national academy of clinical biochemistry presents laboratory medicine practice guidelines: evidence-based practice for point-of-care testing. AACC Press, Washington, DC, pp 135–143

    Google Scholar 

  19. Smith V, Devane D, Begley CM, Clarke M, Higgins S (2007) A systematic review and quality assessment of systematic reviews of fetal fibronectin and transvaginal length for predicting preterm birth. Eur J Obstet Gynecol Reprod Biol 133:134–142

    Article  CAS  PubMed  Google Scholar 

  20. Salfelder A, Kagerah M, Nugent W, Hickl EJ (1992) Detection of fibronectin for confirming the diagnosis of premature rupture of fetal membranes. Geburtshilfe Frauenheilkd; 52(12):730–733 [Article in Germany]

    Article  CAS  PubMed  Google Scholar 

  21. Eriksen NL, Parisi VM, Daoust S, Flamm B, Garite TJ, Cox SM (1992) Fetal fibronectin: a method for detecting the presence of amniotic fluid. Obstet Gynecol 80(3 Pt 1):451–454

    CAS  PubMed  Google Scholar 

  22. Gu H, Ding Y, Li Y (1995) Fetal fibronectin diagnosis of premature rupture of the amniotic membranes. Zhonghua Fu Chan Ke Za Zhi 30(9):533–535 [Article in Chinese]

    CAS  PubMed  Google Scholar 

  23. Gaucherand P, Guibaud S, Awada A, Rudigoz RC (1995) Comparative study of three amniotic fluid markers in premature rupture of membranes: fetal fibronectin, alpha-fetoprotein, diamino-oxidase. ACIU Obstet Gynecol Scand 74:118–121

    Article  CAS  Google Scholar 

Download references

Acknowledgments

I would like to thank Doctor/Hanan H. Makhlouf, for her continuous advice for publication of the manuscript.

Conflict of interest

I declare that no actual or potential conflict of interest in relation to this article exists.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Ain Shams University, Abbassia, Cairo, Egypt

    Ibrahim A. Abdelazim

  2. Ahmadi Hospital, Kuwait Oil Company (KOC), P.O.Box: 9758, 61008, Ahmadi, Kuwait

    Ibrahim A. Abdelazim

Authors
  1. Ibrahim A. Abdelazim
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ibrahim A. Abdelazim.

About this article

Cite this article

Abdelazim, I.A. Fetal fibronectin (Quick Check fFN test®) for detection of premature rupture of fetal membranes. Arch Gynecol Obstet 287, 205–210 (2013). https://doi.org/10.1007/s00404-012-2548-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-012-2548-3

Keywords

Search

Navigation