2010 Group Project 5 - Revision history

MarkHill at 00:44, 7 October 2010

2010-10-07T00:44:49Z

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			<div style="background:#F5FFFA; border: 1px solid #CEF2E0; padding: 1em; margin: auto; width: 98%; float:left;"><div style="margin:0;background-color:#cef2e0;font-family:sans-serif;font-size:120%;font-weight:bold;border:1px solid #a3bfb1;text-align:left;color:#000;padding-left:0.4em;padding-top:0.2em;padding-bottom:0.2em;">Notice - Mark Hill</div>This page is an undergraduate science embryology student [[Template:Projects10\|Group Project 2010]].</div>
	=Fetal Fibronectin=		=Fetal Fibronectin=

MarkHill: Protected "2010 Group Project 5": end of project ([edit=sysop] (indefinite) [move=sysop] (indefinite))

2010-10-07T00:29:11Z

Protected "2010 Group Project 5": end of project ([edit=sysop] (indefinite) [move=sysop] (indefinite))

← Older revision	Revision as of 10:29, 7 October 2010
(No difference)

Z3318446: /* Current Research */

2010-10-06T12:35:51Z

Current Research

Z3318446: /* Current Research */

2010-10-06T12:32:09Z

Current Research

Z3318446: /* Current Research */

2010-10-06T12:31:04Z

Current Research

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	==Current Research==		==Current Research==

			How does a preterm birth happen?
	The fFN(fetal fibronectin) remains relatively very low levels throughout the first 22 weeks of gestation. The following dramatically increase of the concentration that reaches 50 ng/mL or over from 22nd week onwards associates with the increase of the incidence of preterm labor before week 37th of gastation.<ref>Akush Ginekol (Sofiia). 2010;49(2):39-42. Bulgarian.</ref>		The fFN(fetal fibronectin) remains relatively very low levels throughout the first 22 weeks of gestation. The following dramatically increase of the concentration that reaches 50 ng/mL or over from 22nd week onwards associates with the increase of the incidence of preterm labor before week 37th of gastation.<ref>Akush Ginekol (Sofiia). 2010;49(2):39-42. Bulgarian.</ref>

			What is the indicator of a preterm birth?
	According to a study carried out in a teaching hospital, the presence of fetal fibronectin in the cervicovaginal secretions of preterm birth symptomatic women indicates a significant risk for subsequent preterm birth while the absence of fetal fibronectin in this group of woman is a very strong indication that subsequent preterm birth is unlikely to occur.<ref name="PMID8688390"><pubmed>8688390</pubmed></ref>		According to a study carried out in a teaching hospital, the presence of fetal fibronectin in the cervicovaginal secretions of preterm birth symptomatic women indicates a significant risk for subsequent preterm birth while the absence of fetal fibronectin in this group of woman is a very strong indication that subsequent preterm birth is unlikely to occur.<ref name="PMID8688390"><pubmed>8688390</pubmed></ref>

			How accurate is fetal fibrinectin in preterm birth prediction?
	The findings are, the preterm birth (before 37 weeks of gestation) rate in the population studied was 19.1%. Fetal fibronectin predicted preterm birth with sensitivity of 63%, specificity of 95.6%, positive		The findings are, the preterm birth (before 37 weeks of gestation) rate in the population studied was 19.1%. Fetal fibronectin predicted preterm birth with sensitivity of 63%, specificity of 95.6%, positive
	predictive value of 77.3%, and negative predictive value of 91.6%. A negative test accurately excluded		predictive value of 77.3%, and negative predictive value of 91.6%. A negative test accurately excluded
	(97.9%) the chance of subsequent birth during the three weeks interval following sampling.<ref name="PMID8688390 "/>A study with objective to determine the accuracy with which cervico-vaginal fetal fibronectin predicts preterm delivery using systematic quantitative overview of the available literature, concludes that fetal fibronectin test is the most accurate in predicting spontaneous preterm birth within 7 to 10 days after the test of symptomatic woman before advanced cervical dilatation.		(97.9%) the chance of subsequent birth during the three weeks interval following sampling.<ref name="PMID8688390 "/>A study with objective to determine the accuracy with which cervico-vaginal fetal fibronectin predicts preterm delivery using systematic quantitative overview of the available literature, concludes that fetal fibronectin test is the most accurate in predicting spontaneous preterm birth within 7 to 10 days after the test of symptomatic woman before advanced cervical dilatation.

			The accuracy of fFN varies in asymtomatic and symtomatic women.
	A total of 26 876 women involved in the study and among asymptomatic women the best summary likelihood		A total of 26 876 women involved in the study and among asymptomatic women the best summary likelihood
	ratio for positive results was 4.01, 95% confidence interval 2.93 to 5.49 for predicting birth before 34		ratio for positive results was 4.01, 95% confidence interval 2.93 to 5.49 for predicting birth before 34
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	within 7-10 days of testing, with corresponding ratio for negative results of 0.25.		within 7-10 days of testing, with corresponding ratio for negative results of 0.25.

			What does the current research say about this test?
	Although the test has been commonly used in labour and delivery units to help in the management of		Although the test has been commonly used in labour and delivery units to help in the management of
	preterm labour asymptomatic woman, yet it is not an official screening method to be used of pregnant		preterm labour asymptomatic woman, yet it is not an official screening method to be used of pregnant

Z3318446: /* Preventions */

2010-10-06T12:03:53Z

Preventions

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	===~~Preventions~~===		===What`s following the positive results?===

	From the perspective of infant health,preventions or treatments for fetal fibronection test positive woman can be divided into 3 types:		From the perspective of infant health,preventions or treatments for fetal fibronection test positive woman can be divided into 3 types:

Z3318446: /* Preventions */

2010-10-06T12:01:58Z

Preventions

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	There is no side effects in this test, rather the use of fFN test in routine clinical practice allows management and resources to be targeted more appropriately and may limit unnecessary interventions.<ref name="PMID16953860"><pubmed>16953860</pubmed></ref>		There is no side effects in this test, rather the use of fFN test in routine clinical practice allows management and resources to be targeted more appropriately and may limit unnecessary interventions.<ref name="PMID16953860"><pubmed>16953860</pubmed></ref>

	~~==Preventions==~~

	~~From the perspective of infant health,preventions or treatments for fetal fibronection test positive woman can be divided into 3 types:~~

	~~a.Primary prevention - turning preterm birth to at term birth.~~

	~~b.Secondary Prevention - intervening before preterm birth.~~

	~~c.Tertiary Prevention - treatments for premature infants.~~

	~~However,the progress has mainly been made in the latter two preventions.~~

	The secondary prevention involves the regionalisation of perinatal and neonatal care which ,including matenal transport of impending preterm births and the use of antepartum steroid to speed up the maturation of postnatal lungs.

	Tertiary prevention involves developments in neonatal intensive care such as ventilator management and surfactant treatment. It has had a substantial impact on infant mortality yet has less notably affected rates of long-term sequelae.

	~~The secondary and tertiary prevention measures together have lowered gestational age-specific neonatal~~
	~~mortality rates.<ref><pubmed>PMC1508187</pubmed></ref>~~

	==External Links==		==External Links==

Z3318446: /* What next? */

2010-10-06T12:00:15Z

What next?

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	===~~What next?~~===		===Preventions===

			From the perspective of infant health,preventions or treatments for fetal fibronection test positive woman can be divided into 3 types:

			a.Primary prevention - turning preterm birth to at term birth.

			b.Secondary Prevention - intervening before preterm birth.

			c.Tertiary Prevention - treatments for premature infants.

			However,the progress has mainly been made in the latter two preventions.

			The secondary prevention involves the regionalisation of perinatal and neonatal care which ,including matenal transport of impending preterm births and the use of antepartum steroid to speed up the maturation of postnatal lungs.

			Tertiary prevention involves developments in neonatal intensive care such as ventilator management and surfactant treatment. It has had a substantial impact on infant mortality yet has less notably affected rates of long-term sequelae.

			The secondary and tertiary prevention measures together have lowered gestational age-specific neonatal
			mortality rates.<ref><pubmed>PMC1508187</pubmed></ref>

	The predicted results attained by the Fetal fibronectin test determine the actions of the mother and the health care workers within the next two week period. If the results are positive, some or all of the following actions will follow thereafter:		The predicted results attained by the Fetal fibronectin test determine the actions of the mother and the health care workers within the next two week period. If the results are positive, some or all of the following actions will follow thereafter:

Z3291079: /* Fetal Fibronectin */

2010-10-06T10:02:54Z

Fetal Fibronectin

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	The Fetal Fibronectin (fFN) test measures the amount of secretions of fFN from a woman's vagina and cervix. This technique is used to determine the likelihood of a premature birth occurring. Fetal fibronectin is a protein based plasma that acts as a form of glue attaching the amniotic sac to the uterine wall. Fetal fibronectin is commonly present around the amniotic cavity between 22 to 35 weeks of pregnancy, but is released into the cervix and upper vagina toward the onset of labour. If the test finds fFN amongst the upper vagina, between this period, the woman will have a chance of going into early labour<ref>2010 March of Dimes Foundation http://www.marchofdimes.com/professionals/14332_1149.asp</ref>. Hence, if there is no fFN found, it is most likely that they woman will not going into pre-term labour. Therefore, this test allows the woman to see if they are at risk or not.		The Fetal Fibronectin (fFN) test measures the amount of secretions of fFN from a woman's vagina and cervix. This technique is used to determine the likelihood of a premature birth occurring. Fetal fibronectin is a protein based plasma that acts as a form of glue attaching the amniotic sac to the uterine wall. Fetal fibronectin is commonly present around the amniotic cavity between 22 to 35 weeks of pregnancy, but is released into the cervix and upper vagina toward the onset of labour. If the test finds fFN amongst the upper vagina, between this period, the woman will have a chance of going into early labour<ref>2010 March of Dimes Foundation http://www.marchofdimes.com/professionals/14332_1149.asp</ref>. Hence, if there is no fFN found, it is most likely that they woman will not going into pre-term labour. Therefore, this test allows the woman to see if they are at risk or not.

	====About preterm births====		====About preterm births====
	Preterm births refer to labour that occurs early than expected. Preterm labour occurs prior to 37 weeks of gestation, Signs include:<ref>2010 March of Dimes Foundation http://www.marchofdimes.com/professionals/14332_1149.asp</ref>		Preterm births refer to labour that occurs early than expected. Preterm labour occurs prior to 37 weeks of gestation, Signs include:<ref>2010 March of Dimes Foundation http://www.marchofdimes.com/professionals/14332_1149.asp</ref>
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	The fetal Fibronectin test involves a clinician placing a speculum into the vagina. A cotton swab is then used to collect a sample of the cervico-vaginal secretions in the cervical canal/posterior fornix. This sample is then sent to a Laboratory that analyses it, producing the results within 24 hours of the test. The necessity of the use of the speculum has been questioned in recent years. Studies have shown that the insertion of a finger to guide the cotton swab toward the posterior fornix of the vagina is just as effective as Adeza approved method. <ref><pubmed>18355785</pubmed></ref>		The fetal Fibronectin test involves a clinician placing a speculum into the vagina. A cotton swab is then used to collect a sample of the cervico-vaginal secretions in the cervical canal/posterior fornix. This sample is then sent to a Laboratory that analyses it, producing the results within 24 hours of the test. The necessity of the use of the speculum has been questioned in recent years. Studies have shown that the insertion of a finger to guide the cotton swab toward the posterior fornix of the vagina is just as effective as Adeza approved method. <ref><pubmed>18355785</pubmed></ref>

			[[File:FFN_test2.jpg\|thumb\|Fetal Fibronectin Procedure Image\|320px\|centre]]

	===Laboratory procedure===		===Laboratory procedure===

Z3291079 at 09:58, 6 October 2010

2010-10-06T09:58:31Z

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	• '''Multifetal pregnancies''': Approximately 60% of multifetal births occur prior to the 37th week<ref>. Singer E, Pilpel S, Bsat F, et al. Accuracy of fetal fibronectin to predict preterm birth in twin gestations with symptoms of labor. Obstet Gynecol. 2007 May;109(5):1083-87</ref>.		• '''Multifetal pregnancies''': Approximately 60% of multifetal births occur prior to the 37th week<ref>. Singer E, Pilpel S, Bsat F, et al. Accuracy of fetal fibronectin to predict preterm birth in twin gestations with symptoms of labor. Obstet Gynecol. 2007 May;109(5):1083-87</ref>.

			==Procedure of the Fetal Fibronectin Test==

			The fetal Fibronectin test involves a clinician placing a speculum into the vagina. A cotton swab is then used to collect a sample of the cervico-vaginal secretions in the cervical canal/posterior fornix. This sample is then sent to a Laboratory that analyses it, producing the results within 24 hours of the test. The necessity of the use of the speculum has been questioned in recent years. Studies have shown that the insertion of a finger to guide the cotton swab toward the posterior fornix of the vagina is just as effective as Adeza approved method. <ref><pubmed>18355785</pubmed></ref>

← Older revision		Revision as of 22:35, 6 October 2010
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	==Current Research==		==Current Research==

	How does a preterm birth happen?		===How does a preterm birth happen?===

	The fFN(fetal fibronectin) remains relatively very low levels throughout the first 22 weeks of gestation. The following dramatically increase of the concentration that reaches 50 ng/mL or over from 22nd week onwards associates with the increase of the incidence of preterm labor before week 37th of gastation.<ref>Akush Ginekol (Sofiia). 2010;49(2):39-42. Bulgarian.</ref>		The fFN(fetal fibronectin) remains relatively very low levels throughout the first 22 weeks of gestation. The following dramatically increase of the concentration that reaches 50 ng/mL or over from 22nd week onwards associates with the increase of the incidence of preterm labor before week 37th of gastation.<ref>Akush Ginekol (Sofiia). 2010;49(2):39-42. Bulgarian.</ref>

	What is the indicator of a preterm birth?		===What is the indicator of a preterm birth?===

	According to a study carried out in a teaching hospital, the presence of fetal fibronectin in the cervicovaginal secretions of preterm birth symptomatic women indicates a significant risk for subsequent preterm birth while the absence of fetal fibronectin in this group of woman is a very strong indication that subsequent preterm birth is unlikely to occur.<ref name="PMID8688390"><pubmed>8688390</pubmed></ref>		According to a study carried out in a teaching hospital, the presence of fetal fibronectin in the cervicovaginal secretions of preterm birth symptomatic women indicates a significant risk for subsequent preterm birth while the absence of fetal fibronectin in this group of woman is a very strong indication that subsequent preterm birth is unlikely to occur.<ref name="PMID8688390"><pubmed>8688390</pubmed></ref>

	How accurate is fetal fibrinectin in preterm birth prediction?		===How accurate is fetal fibrinectin in preterm birth prediction?===

	The findings are, the preterm birth (before 37 weeks of gestation) rate in the population studied was 19.1%. Fetal fibronectin predicted preterm birth with sensitivity of 63%, specificity of 95.6%, positive		The findings are, the preterm birth (before 37 weeks of gestation) rate in the population studied was 19.1%. Fetal fibronectin predicted preterm birth with sensitivity of 63%, specificity of 95.6%, positive
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	(97.9%) the chance of subsequent birth during the three weeks interval following sampling.<ref name="PMID8688390 "/>A study with objective to determine the accuracy with which cervico-vaginal fetal fibronectin predicts preterm delivery using systematic quantitative overview of the available literature, concludes that fetal fibronectin test is the most accurate in predicting spontaneous preterm birth within 7 to 10 days after the test of symptomatic woman before advanced cervical dilatation.		(97.9%) the chance of subsequent birth during the three weeks interval following sampling.<ref name="PMID8688390 "/>A study with objective to determine the accuracy with which cervico-vaginal fetal fibronectin predicts preterm delivery using systematic quantitative overview of the available literature, concludes that fetal fibronectin test is the most accurate in predicting spontaneous preterm birth within 7 to 10 days after the test of symptomatic woman before advanced cervical dilatation.

	The ~~accuracy~~ of fFN ~~varies~~ in asymtomatic and symtomatic women.		===The variation of fFN accuracy in asymtomatic and symtomatic women===

	A total of 26 876 women involved in the study and among asymptomatic women the best summary likelihood		A total of 26 876 women involved in the study and among asymptomatic women the best summary likelihood
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	within 7-10 days of testing, with corresponding ratio for negative results of 0.25.		within 7-10 days of testing, with corresponding ratio for negative results of 0.25.

	What does the current research say about this test?		===What does the current research say about this test?===

	Although the test has been commonly used in labour and delivery units to help in the management of		Although the test has been commonly used in labour and delivery units to help in the management of

← Older revision		Revision as of 22:32, 6 October 2010
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	How does a preterm birth happen?		How does a preterm birth happen?

	The fFN(fetal fibronectin) remains relatively very low levels throughout the first 22 weeks of gestation. The following dramatically increase of the concentration that reaches 50 ng/mL or over from 22nd week onwards associates with the increase of the incidence of preterm labor before week 37th of gastation.<ref>Akush Ginekol (Sofiia). 2010;49(2):39-42. Bulgarian.</ref>		The fFN(fetal fibronectin) remains relatively very low levels throughout the first 22 weeks of gestation. The following dramatically increase of the concentration that reaches 50 ng/mL or over from 22nd week onwards associates with the increase of the incidence of preterm labor before week 37th of gastation.<ref>Akush Ginekol (Sofiia). 2010;49(2):39-42. Bulgarian.</ref>

	What is the indicator of a preterm birth?		What is the indicator of a preterm birth?

	According to a study carried out in a teaching hospital, the presence of fetal fibronectin in the cervicovaginal secretions of preterm birth symptomatic women indicates a significant risk for subsequent preterm birth while the absence of fetal fibronectin in this group of woman is a very strong indication that subsequent preterm birth is unlikely to occur.<ref name="PMID8688390"><pubmed>8688390</pubmed></ref>		According to a study carried out in a teaching hospital, the presence of fetal fibronectin in the cervicovaginal secretions of preterm birth symptomatic women indicates a significant risk for subsequent preterm birth while the absence of fetal fibronectin in this group of woman is a very strong indication that subsequent preterm birth is unlikely to occur.<ref name="PMID8688390"><pubmed>8688390</pubmed></ref>

	How accurate is fetal fibrinectin in preterm birth prediction?		How accurate is fetal fibrinectin in preterm birth prediction?

	The findings are, the preterm birth (before 37 weeks of gestation) rate in the population studied was 19.1%. Fetal fibronectin predicted preterm birth with sensitivity of 63%, specificity of 95.6%, positive		The findings are, the preterm birth (before 37 weeks of gestation) rate in the population studied was 19.1%. Fetal fibronectin predicted preterm birth with sensitivity of 63%, specificity of 95.6%, positive
	predictive value of 77.3%, and negative predictive value of 91.6%. A negative test accurately excluded		predictive value of 77.3%, and negative predictive value of 91.6%. A negative test accurately excluded
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	The accuracy of fFN varies in asymtomatic and symtomatic women.		The accuracy of fFN varies in asymtomatic and symtomatic women.

	A total of 26 876 women involved in the study and among asymptomatic women the best summary likelihood		A total of 26 876 women involved in the study and among asymptomatic women the best summary likelihood
	ratio for positive results was 4.01, 95% confidence interval 2.93 to 5.49 for predicting birth before 34		ratio for positive results was 4.01, 95% confidence interval 2.93 to 5.49 for predicting birth before 34
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	What does the current research say about this test?		What does the current research say about this test?

	Although the test has been commonly used in labour and delivery units to help in the management of		Although the test has been commonly used in labour and delivery units to help in the management of
	preterm labour asymptomatic woman, yet it is not an official screening method to be used of pregnant		preterm labour asymptomatic woman, yet it is not an official screening method to be used of pregnant