Background
abruption, PTB
PRETERM BIRTH, PRETERM LABOUR, POOR UTERINE CONTRACTIONS, INFLAMMATION, IRREGULAR UTERINE CONTRACTIONS
Preterm birth (PTB), defined as delivery prior to 37 weeks gestation is a major global health issue, affecting 15 million births worldwide [Traditionally the diagnosis of preterm labour is made by regular uterine contractions with cervical effacement or dilatation at preterm gestation Studies have shown that symptomatic women with a shortened cervix (< 15 mm) are at a higher risk of PTB [fFN is an extracellular matrix protein present at the decidual- chorionic interface. Disruption of this interface due to inflammation, abruption, or uterine contractions releases fFN into cervicovaginal secretions, which lays the basis for PTB prediction. Qualitative fFN have been extensively studied. In 2013, a systematic review of 5 randomized trials and 15 diagnostic test accuracy studies evaluating cervicovaginal fFN for predicting PTB in women with symptoms of preterm labour reported the pooled estimated sensitivity and specificity of 76.7% and 82.7% for delivery within 7 days of testing. The high negative predictive value (98–100% for delivery within 7 or 14 days of testing [Quantitative fFN measurement with the knowledge of the fFN concentration appears to further improve the predictive value. A meta-analysis in 2021, which included 15 studies and 6113 women with or without symptoms of preterm labour, concluded that the pooled sensitivities for thresholds of 10, 50, 200, and 500 ng/ml were 0.78, 0.56, 0.33, and 0.11 and pooled specificities were 0.63, 0.84, 0.96, and 0.99, respectively for detection of PTB at less than 34 weeks of gestation [The use of qualitative fFN test for management of patients with symptoms of preterm labour is recommended by various authorities [