Diagnostic Accuracy of PremaQuick versus Actim Partus in Prediction of Preterm Labor in Symptomatic Women within 14 Days

• 作者: Bassam Nusair Ibrahim A. Abdelazim Mohannad Abu-Faza Rania H. Farag Shikanova Svetlana Sreelatha R. Nair
• 来源期刊: 妇产科期刊(英文)
• 学科: 医学
• 关键词: PremaQuick Actim Partus PRETERM LABOR
• 年，卷（期）: 2018,（8）
• 页码范围: 741-755
• 页数: 15页
• 分类号: R73

摘要

Background: Preterm labor (PTL) remains a major source of neonatal morbidity, and mortality. Currently the trans-vaginal cervical length (TVCL), and/or cervico-vaginal fetal fibronectin (fFN) are the common diagnostic tools used for prediction of PTL. Consequently, many women and their fetuses are exposed unnecessarily tocolysis and hospital admission. Objectives: This study was designed to compare the diagnostic accuracy of PremaQuick versus Actim Partus in prediction of PTL in symptomatic women within 14 days. Patients and Methods: Two-hundred and twenty women (220) were included in this comparative prospective study and classified into two groups: 110 women with threatened preterm labor (TPTL) in the study group, and 110 controls (no TPTL). Women included in the study were subjected to: through history, collection of the cervico-vaginal fluid (CVF) samples for assessment by PremaQuick and Actim Partus tests, followed by trans-vaginal cervical length (TVCL) assessment. Studied women managed according to the hospitals protocol, with follow-up weekly in the obstetrics outpatients’ clinic after discharge from the hospital until delivery. The main outcome measures the diagnostic accuracy of PremaQuick versus Actim Partus in prediction of PTL in symptomatic women within 14 days of admission. Results: PremaQuick test was significantly more specific with higher positive predictive value (PPV) in prediction of PTL in symptomatic women within 14 days (95.5% and 89.6%;respectively) compared to CL 25 mm (56.3% and 54.6%;respectively), (P = 0.02 and 0.03;respectively). In addition, PremaQuick test was significantly more sensitive with higher positive predictive value (PPV) in prediction of PTL in symptomatic women within 14 days (39.8% and 89.6%;respectively) compared to Actim Partus (13.9% and 55.5%;respectively), (P = 0.001 and 0.01;respectively). The Odds ratio and the relative risk for prediction of PTL in symptomatic women within 14 days were significantly high for PremaQuick compared to the CL 25 mm, and Actim Part