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Figure 8 Methodological quality of studies included in the systematic review of accuracy of digital examination in predicting spontaneous preterm birth. Data presented as 100% stacked bars. Figures in the stacks represent number of studies. Cohort Prospective design Consecutive recruitment Adequate test description Blinding Cohort Prospective design Consecutive recruitment Adequate test description Blinding 2 Asymptomatic women 4 Symptomatic women 8 1 1 1 1 1 49 9 9 Yes No, unclear or unreported 7 5 1
Figure 9 Forest plots of likelihood ratios (LR’s) of digital examination in predicting spontaneous preterm birth as a predictor of spontaneous preterm birth Study Asympto matic w ome n
Page 1 and 2: ACCURACY OF TESTS FOR PREDICTING SP
Page 3 and 4: Abstract Spontaneous preterm birth
Page 5 and 6: Acknowledgements In undertaking thi
Page 7 and 8: Table of contents Chapter 1 Thesis
Page 9 and 10: Absence of fetal breathing movement
Page 11 and 12: Figure 15 Forest plots of likelihoo
Page 17 and 18: eference standards (outcome of spon
Page 19 and 20: Table 18 Individual accuracy result
Page 21 and 22: Table 48 Characteristics of test ac
Page 23 and 24: labour. Literature was identified f
Page 25 and 26: 8) strategies needs to be explored.
Page 27 and 28: morbidities, which often lengthen h
Page 29 and 30: anticipating a normal course of pre
Page 31 and 32: The second population of interest i
Page 33 and 34: Chapter 3 Methods Protocol developm
Page 35 and 36: stage process using predefined and
Page 37 and 38: Table 1 List of tests that purporte
Page 39 and 40: corresponding authors so that only
Page 41 and 42: Figure 2 Flow chart of procedures f
Page 43 and 44: Figure 3 Identification of test acc
Page 45 and 46: with one previous spontaneous prete
Page 47 and 48: Figure 6 Plot of sensitivity agains
Page 49: predicting spontaneous preterm birt
Page 53 and 54: within 7-10 days of testing in addi
Page 55 and 56: Figure 10 Methodological quality of
Page 57 and 58: Figure 13 Plot of sensitivity again
Page 63 and 64: Cervico-vaginal prolactin During pr
Page 69 and 70: women had reported spontaneous pret
Page 75 and 76: Serum α-fetoprotein (MSAFP) A high
Page 81 and 82: Accuracy of maternal serum relaxin
Page 85 and 86: Only two studies used the same thre
Page 87 and 88: β-human chorionic gonadotrophin (
Page 89 and 90: showed asymmetry indicating presenc
Page 93 and 94: Estriol Estriol is produced by both
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Figure 48 Methodological quality of
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Figure 51 Forest plots of likelihoo
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Interleukin-6 (IL6) Interleukin 6 (
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epresented the largest higher quali
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Figure 57 Plot of sensitivity again
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two-weekly interval. For symptomati
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Matrix metalloproteases-9 (MMP-9) D
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All but one study assessed women’
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Asymptomatic bacteriuria assessment
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Gram staining using Spiegel’s 232
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Mammary stimulation test Antenatal
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Uterine activity monitoring Presenc
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Accuracy of uterine activity monito
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Rheobase Rheobase in the context of
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Absence of fetal breathing movement
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Cervical ultrasound assessment Ante
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Accuracy of cervical length and fun
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gestation or birth with 48 hours of
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The main accuracy results are summa
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Figure 100 Summary forest plots of
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Screening typically involves use of
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Table 3 Summary of tests’ accurac
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Table 5 Summary of tests’ accurac
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Chapter 6 Discussion Methodological
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completely as would have been desir
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antenatal women population, using a
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final common pathway of spontaneous
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effectiveness), there are no practi
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Recommendations for research • Ne
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modelling project should make provi
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188
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Appendix II - Search strategies MED
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111. (premature adj3 rupture adj3 m
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92. Granuloma Inguinale/ 93. mycopl
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s (oncofetal or c-reactive)(w)(prot
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s (uterine or antepartum)(3w)(hemor
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interpregnancy and interval* or occ
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((((physical next exam) or (physica
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Appendix IV - Characteristics and r
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Table 12 Characteristics of test ac
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Table 13 Individual accuracy result
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Table 14 Characteristic of studies
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Symptomatic Luzzi 110 2003 133 Coho
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Peaceman 79 1997 725 Cohort Prospec
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Rozenberg 128 1997 76 Calda 120 199
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Elizur 144 2005 35 Cohort Prospecti
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Table 21 Characteristics of the inc
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Table 23 Characteristics of studies
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Liu 183 1999 USA 72 Case-control Re
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*TP = true positive, FP = false pos
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Silver 219 1993 USA 29 Cohort Prosp
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Turhan 230 2000 Turkey 82 Cohort Pr
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34 weeks Rizzo 1 217 18 0 34 40 0.3
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Stuart 273 1965 UK 817 Case-control
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Helou, 1996 292 Israel Cohort Blind
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Krohn, 1991 302 USA Prospective Tes
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Holst 232 Spiegel 9 3 13 24 0.41 0.
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Castle 312 1983 English Cohort Pros
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Another method for assessing hetero
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Publications directly contributing
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15. Martin JA, Hamilton BE, Sutton
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44. Honest H, Bachmann LM, Knox EM,
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72. Parikh MN,.Mehta AC. Internal c
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99. Vercoustre L, Sotter S, Bouige
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126. Pieta-Dolinska A, Jaczewski B,
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preterm delivery but not with fetal
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and activin A in maternal serum: pr
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199. Foulon W, Van Liedekerke D, De
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223. Kurkinen-Raty M, Ruokonen A, V
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249. Radnai M, Gorzo I, Nagy E, Urb
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281. Spiegel CA, Amsel R, Eschenbac
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307. Guinn DA, Wigton TR, James JA,
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334. Daskalakis G, Thomakos N, Hatz
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