Cervicovaginal fetal Fibronectin in Predicting Success of Induced Labour among Nulliparous Women

宫颈阴道胎儿纤连蛋白在预测初产妇引产成功率中的作用

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Abstract

BACKGROUND: Induction of labour is a routine and common obstetric intervention which aims at achieving successful vaginal delivery. Over the years, attempts have been made to find a pre-induction test that can predict the success of induced labour, which may also serve as a selection criterion for determining which women should undergo labour induction. The study aims to determine whether the presence of fetal fibronectin in the cervicovaginal secretion can predict the success of induced labour. METHODOLOGY: This was a cohort study involving 137 nulliparous women at term undergoing induction of labour. The presence of fetal fibronectin in the cervicovaginal secretion was determined using a fetal fibronectin rapid immunoassay kit. Induction of labour was done using misoprostol. RESULTS: Data obtained were analysed using statistical product and service solutions (IBM-SPSS) version 20.0. Data obtained were tested for normality of distribution and compared by Chi square, Students' t-test, or Mann-Whitney U as appropriate. A p-value of less than 0.05 was regarded as significant. The rate of vaginal delivery was not significantly different between fetal fibronectin positive and negative women (65% vs. 66.7%, p value- 0.839). Women who were positive for fibronectin had a significantly shorter mean duration of induction (22.8+6.1 hours versus 30.1 + 11.1 hours, P value of 0.015), had higher bishop's scores, and required fewer doses of misoprostol. Regression analysis did not find fetal fibronectin to be predictive of vaginal delivery. CONCLUSION: The Presence of fetal fibronectin was not predictive of successful labour induction. Its presence may possibly be associated with a relatively shorter duration of induction.

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