A comparison of speculum and nonspeculum collection of cervicovaginal specimens for fetal fibronectin testing

Am J Obstet Gynecol. 2008 Aug;199(2):131.e1-4. doi: 10.1016/j.ajog.2008.02.013. Epub 2008 Mar 20.

Abstract

Objective: Current recommendations include the use of a vaginal speculum for fetal fibronectin specimen collection. This article evaluates the equivalency of nonspeculum methods for collecting fetal fibronectin specimens.

Study design: Two separate prospective studies of patients more than 22 weeks' gestation were performed at 2 institutions with similar hypotheses and methods. Two sequential specimens were collected on each patient: 1 with speculum and 1 with the nonspeculum method. The order of collection was reversed or randomized in both studies. Two alternative nonspeculum collection methods are described.

Results: The 2 study sample sizes were 169 and 31. Comparison of the fetal fibronectin test results between the speculum and nonspeculum methods demonstrated greater than 95% agreement with an intraclass Kappa coefficient greater than 0.85 in both studies. The order of collection did not result in significantly different fetal fibronectin averages.

Conclusion: These studies demonstrate that there is excellent agreement between fetal fibronectin results obtained by speculum and nonspeculum collection methods.

Publication types

  • Comparative Study

MeSH terms

  • Cervix Uteri / chemistry*
  • Female
  • Fetus / metabolism*
  • Fibronectins / analysis*
  • Humans
  • Obstetric Labor, Premature / diagnosis*
  • Predictive Value of Tests
  • Pregnancy
  • Reproducibility of Results
  • Specimen Handling / instrumentation
  • Specimen Handling / methods*
  • Surgical Instruments
  • Vagina / chemistry*

Substances

  • Fibronectins