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    Value of cervicovaginal prolactin in the prediction of spontaneous preterm delivery
    (Parthenon Publishing Group, 1999) Koca, ZD; Oztekin, MK; Karadadas, N; Ozsener, S; Asena, U
    Objective Our purpose was to determine whether decidual prolactin could be identified in cervicovaginal secretions during pregnancy and whether its occurrence was associated with preterm delivery. Methods A prospective cohort: study was performed in 75 pregnant women. The study group comprised 35 patients hospitalized with the diagnosis of preterm labor or threatened preterm labor (11 and 24 patients, respectively) and the control group consisted of 40 asymptomatic outpatients. The cervicovaginal samples were collected with cervicovaginal washing and were then centrifuged. The supernatant was stored at -50 degrees C and the cervicovaginal prolactin levels were determined by radioimmunoassay. A prolactin concentration greater than the cut-off value calculated from the control group was considered positive. Results The median prolactin values in the 11 patients diagnosed with preterm labor were higher than in the control group (p < 0.05). The proportion of inpatients delivered at < 37 weeks' gestation was significantly greater in the group with positive prolactin values than in those testing negative in both the study and the control groups (p<0.01). The cervicovaginal prolactin assessment had an 82.3% positive predictive value and a 66.6% negative predictive value for delivery at <37 weeks' gestation in the symptomatic patients. Conclusions Cervicovaginal prolactin assessment as a biochemical marker may be used for the prediction of preterm delivery. It may also be used as a screening method for asymptomatic gravidas. Although there are not enough conclusive studies proving the use of cervicovaginal prolactin as a practical clinical assessment tool, there should be further studies of the biochemical markers of the decidual membranes, and of the cytotrophoblasts.