title: Fetal fibronectin as a predictor of vaginal birth in nulliparas undergoing preinduction cervical ripening.
abstract: OBJECTIVE
  We sought to evaluate whether the presence of a positive fetal fibronectin (> or = 50 ng/mL) in nulliparous women undergoing preinduction cervical ripening with the intracervical Foley catheter predicted vaginal birth.
  
  
  METHODS
  This was a prospective blinded observational trial of nulliparous women undergoing preinduction cervical ripening. We excluded women who had a contraindication to vaginal birth. Cervical and vaginal fetal fibronectin specimens were obtained before preinduction cervical ripening with an intracervical Foley catheter. The managing obstetrician was blinded to these results.
  
  
  RESULTS
  A total of 241 women met the inclusion criteria, of which 54.4% delivered vaginally. There was no difference in the rate of vaginal delivery among women with either a positive cervical fetal fibronectin (positive fetal fibronectin 55.8% compared with negative fetal fibronectin 53.3%, P = .70) or positive vaginal fetal fibronectin (positive fetal fibronectin 57.6% compared with negative fetal fibronectin 53.3%, P = .56). Women with a positive cervical fetal fibronectin did have a shorter duration of cervical ripening (fetal fibronectin-positive 229 +/- 220 minutes compared with fetal fibronectin-negative 379 +/- 193 minutes, P < .05), duration of oxytocin (fetal fibronectin-positive 655 +/- 555 minutes compared with fetal fibronectin-negative 731.5 +/- 342 minutes, P < .025) and required lower maximal doses of oxytocin (fetal fibronectin-positive 18.4 mIU/min compared with fetal fibronectin-negative 21.8 mIU/min, P = .005). Women with a positive vaginal fetal fibronectin demonstrated only a shorter duration of cervical ripening compared with their fetal fibronectin negative counterparts (fetal fibronectin-positive 300 +/- 216 minutes compared with fetal fibronectin-negative 345 +/- 201 minutes, P < .05).
  
  
  CONCLUSIONS
  Fetal fibronectin does not predict vaginal delivery in nulliparous women requiring preinduction cervical ripening.
  
  
  METHODS
  II-2.
authors.affiliation: Departments of Obstetrics and Gynecology, Drexel University College of Medicine, 245 N. 15th Street, Mail Stop 495, Philadelphia, PA 19102, USA. Anthony.Sciscione@drexelmed.edu
authors.forename: Anthony
authors.initials: A
authors.lastname: Sciscione
authors.forename: Matthew K
authors.initials: MK
authors.lastname: Hoffman
authors.forename: Samantha
authors.initials: S
authors.lastname: DeLuca
authors.forename: Anne
authors.initials: A
authors.lastname: O'Shea
authors.forename: Jenny
authors.initials: J
authors.lastname: Benson
authors.forename: Marjorie
authors.initials: M
authors.lastname: Pollock
authors.forename: Babak
authors.initials: B
authors.lastname: Vakili
mesh_terms: D000328:Adult; D020070:Cervical Ripening / Q000378:metabolism*; D002584:Cervix Uteri / Q000378:metabolism*; D015331:Cohort Studies; D005260:Female; D005353:Fibronectins / Q000378:metabolism*; D006023:Glycoproteins / Q000378:metabolism*; D006801:Humans; D007751:Labor, Induced; D010298:Parity / Q000502:physiology; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D047929:Term Birth / Q000378:metabolism; D014621:Vagina / Q000378:metabolism*
chemical_list: C403421:FFN protein, human; D005353:Fibronectins; D006023:Glycoproteins