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.
Adeniji
A O
AO
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
Olayemi
O
O
Odukogbe
A A
AA
Oladokun
A
A
Adeniji
O I
OI
Egbewale
B E
BE
Omigbodun
A O
AO
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