[Prediction of successful induction of labor: a comparison between fetal fibronectin assay and the Bishop score].
OBJECTIVE
The aim of our study is to determine whether the fetal fibronectin is a better predictor of successful induction of labor than the Bishop score.


METHODS
A prospective observational non-randomized study was conducted in our unit including 234 patients scheduled for induction of labor from October 2000 to June 2004. Fetal fibronectin was assayed by taking sample from the endocervix and the cervical status was evaluated using the Bishop score. Data were analysed by Chi-square test of Mantel-Haenzel and Cox stepwise multiple regression using SPSS version 12 software.


RESULTS
The likelihood ratios for predicting that vaginal delivery would occur within 24h of induction for positive fetal fibronectine were 1.34 (95% CI 1.04-1.73, p=0.027) all patients included and 1.51(95% CI 1.00-2.33, p=0.048) for the nulliparas and 1.92 (95% CI 1.51-2.42, p=0.0001) for the Bishop score. On multiple regressions, the only variables independently associated with a successful induction were the Bishop score, the parity and the age of the patient. No significant association was found between the presence of cervical fibronectin and the caesarean section rate: 21.84% for positive fibronectin versus 21.78% for negative fibronectin.


CONCLUSIONS
The fetal fibronectine is probably useless in this context, given the additional cost and no improvement compared with the simple Bishop score.
Droulez
A
A
Service d'obstétrique et de gynécologie, centre hospitalier Lyon-Sud (pavillon 3B), 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France. andreea_droulez@hotmail.com
Girard
R
R
Dumas
A-M
AM
Mathian
B
B
Berland
M
M
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D020070:Cervical Ripening; D036861:Delivery, Obstetric; D005260:Female; D005333:Fetus / Q000378:metabolism*; D005353:Fibronectins / Q000032:analysis*; D006801:Humans; D007751:Labor, Induced; D016013:Likelihood Functions; D010298:Parity; D011247:Pregnancy; D011446:Prospective Studies; D012044:Regression Analysis; D055815:Young Adult
D005353:Fibronectins