Fetal Fibronectin as a Predictor of Term Labor and Efficacy of Misoprostol for Cervical Ripening and Labor Induction

Kim, B Y; Shin, B S; Choi, J H; Ko, Y K; Lee, K W; Song, H S; Han, J S; Kim, S D

Abstract

OBJECTIVE
To evaluate the efficacy of misoprostol induced induction of term labor according to the presence fo fetal fibronectin in cervicovaginal secretion.
METHODS
90 women scheduled for induction of labor were examined for Bishop score and were undergone for intravaginal application of 50 microgram of misoprostol at 6 hours interval. Misoprostols were administered continuously unless any of regular labor, spontaneous rupture of membrane or fetal distress occurred. In our study, 49 cases showed fibronectin positive cervicovaginal secretion, 41 cases showed fibronectin negative cervicovaginal secretion, 15 cases undergone for cesarean section.
RESULTS
1. No significant difference were observed in Bishop`s score between the two groups. (4.72+/-0.98 versus 4.47+/-1.05). 2. Mean numbers of misoprostol administration were 1.33+/-0.57 and 2.03+/-1.03 in positive group and negative group respectively. Mean times required from labor induction to vaginal delivery were 470+/-388 min and 861+/-513 min respectively. Vaginal delivery in 12 hours were 79% and 50% in positive group and negative group respectively. 3. Dividing the cases according to the high and low Bishop score with cutoff level Bishop score of 5, mean numbers of misoprostol administration were 1.11+/-0.32 and 2.86+/-0.86 in high score group and low score group respectively. Mean times required from labor induction to vaginal delivery were 380+/-227 min and 1266+/-443 min in high score group and low score group respectively. Vaginal delivery in 12 hours were 89.9% and 14.3% in high score group and low score group respectively.
CONCLUSION
Above study results suggest that fetal fibronectin qualitative immunoassay along with the evaluation of Bishop score might play important role in determining the appropriate timing of labor induction.