dictions and preventions are limited by our lack of knowledge as to where they fit in. The new hope provided by the prostaglandin theory is a shimmer of light in the right direction, yet it research must continue before it can be accepted. The current indices of prediction of Spontaneous preterm birth fall mainly along two lines, biophysical and biochemical factors. There are also risk scoring indices by which the risk is evaluated. According to these measurements 50% of spontaneous preterm births occur in women without apparent risks, a reflection of the low accuracy of these methods. 13 The two main biophysical predictors involve the cervix and the uterus. The three methods for examination and prediction of the risk of preterm birth with the cervix are the Bishop score (Digital examination), the Cervical score (Digital examination; cervix length in centimeters minus dilation in centimeters), and an endovaginal ultrasound to measure the length of the cervix. In general, it has been suggested that there is an increased risk of preterm delivery as cervical length decreases. In a study carried out all of these methods yielded low sensitivities and low positive predictive values. 14, 15 In the uterus, a preterm delivery is predicted if uterine activity is above normal. The uterus is monitored at home by a a tocodynamometer. However, the differences are not large enough to be of clinical value. 14, 15 Biochemical indices are highly sought, a simple litmus test would be a quick way to determine the risk level of a pregnant woman. Plasma and serum markers have been searched for but unfortunately there has been no success. Elevated levels of estradiol, progesterone, prostaglandin, and its metabolites have all been measured prior to the onset of preterm labor, all resulting in differences with no diagnostic significance. 13 Cervicovaginal secretions have been tested, primarily for fetal fibronectin. Fetal Fibronectin is a high ...
