Preliminary results of fetal fibronectin testing in twin pregnancies

OBJECTIVES: Purpose of this study is to investigate accuracy of fetal fibronectin testing (fFN test) as a means to predict preterm birth in twin gestations without symptoms of preterm labour as well as to compare the results with the world trends. MATERIAL AND METHODS: This study is prospective and comparative. It covers a period from December 2012 to May 2013, includes a total of 43 twin pregnancies--34 bichoriotic biamniotic twin pregnancies, 6 monochoriotic biamniotic twin pregnancies and 3 monochoriotic monoamniotic twin pregnancy A measurement of cervical length by transvaginal ultrasonography is used as well. RESULTS: A total of 43 women had cervico-vaginal fetal fibronectin testing obtained from 24 to 34 weeks of gestation. 31 women had negative fFN test and 12 had positive results. In patiens with negative testing delivery began after a period of 30 days average. In most of the women with negative test result labour occurred after more than 14 days, which means that the test has high specificity. Patients with positive test result had delivery after a mean period of 12 days, which demonstrated that the fetal fibronectin test has high sensitivity The shortest period between the positive testing and delivery was one day A transvaginal ultrasound measurement of the cervical length was performed. Four of our patients had positive test result as well as short cervix and delivery occurred at a mean age of 31 w.g. and 5 days after the test. Four women tested positive for fFNA and had normal cervical length. They had labour at 35+3 w.g. and 23 days after the test. Eight patients tested negative for fFN and had short cervical length, but they had labour after 28 days as well. Most of the researched women (19) had negative test result and normal cervical length and they delivered after average 30 days. CONCLUSIONS: Fetal fibronectin testing used in twin pregnancies as well as in singleton pregnancies proves to have high specificity sensitivity, good positive and negative predictive value. It offers the opportunity for adequate tocolytic therapy once the test comes out to be positive. There is a posibility to decrease the use of corticosteroids. The length of stay in the hospital can also be reduced.