Cervico-vaginal foetal fibronectin: a predictor of cervical response at pre-induction cervical ripening.
BACKGROUND
Not all pregnant women with an "unripe" cervix can be successfully ripened by the cervical ripening agents; therefore tests with predictive information are justified.


OBJECTIVE
To examine the effect of the presence of foetal fibronectin (FFN) in the cervico-vaginal secretions on pre-induction cervical ripening with either intravaginal Misoprostol or transcervical Foley catheter.


METHODS
Twenty (20) patients managed at a tertiary health institution in South-western Nigeria between March and May 2003 were randomised for cervical ripening by either intravaginal Misoprostol or Transcervical Foley catheters. Cervico-vaginal secretions were assessed for presence of FFN with Foetal Fibronectin Enzyme Immunoassay Kit (Adeza Corp.) prior to commencement of cervical ripening.


METHODS
FFN status, Pre-ripening and Pre-induction modified Bishop scores and duration of cervical ripening.


RESULTS
Ten of the fifteen patients with positive membrane immunoassay for FFN achieved ripened cervix (modified Bishop score > or = 6) within 6 - 12 hours of exposure to the agents of cervical ripening. In the FFN negative group, only 2 of the five patients achieved ripe cervix within the >12 - 18 hours period, the rest being in the >18 - 24 hours period.


CONCLUSIONS
Foetal fibronectin test may offer useful predictive information prior to institution of processes of cervical ripening in patients with unfavourable cervices.
Department of Obstetrics and Gynaecology, Faculty of Clinical Sciences, College of Health Sciences, Ladoke Akintola University of Technology, P. M. B 4400 Osogbo, Osun State, Nigeria. tunji1802@yahoo.com
A O
AO
Adeniji
O
O
Olayemi
A A
AA
Odukogbe
A
A
Oladokun
O I
OI
Adeniji
B E
BE
Egbewale
A O
AO
Omigbodun
D000020:Abortifacient Agents, Nonsteroidal / Q000494:pharmacology* / Q000627:therapeutic use; D000328:Adult; D002404:Catheterization; D020070:Cervical Ripening / Q000187:drug effects*; D002584:Cervix Uteri / Q000187:drug effects*; D005260:Female; D005353:Fibronectins / Q000032:analysis* / Q000187:drug effects; D006023:Glycoproteins / Q000032:analysis* / Q000187:drug effects; D006801:Humans; D007118:Immunoassay; D007751:Labor, Induced / Q000379:methods; D016595:Misoprostol / Q000494:pharmacology* / Q000627:therapeutic use; D011247:Pregnancy; D013997:Time Factors; D014621:Vagina / Q000187:drug effects*
D000020:Abortifacient Agents, Nonsteroidal; C403421:FFN protein, human; D005353:Fibronectins; D006023:Glycoproteins; D016595:Misoprostol