Droulez A, Girard R, Dumas A-M, Mathian B, Berland M
Service d'obstétrique et de gynécologie, centre hospitalier Lyon-Sud (pavillon 3B), 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France.
J Gynecol Obstet Biol Reprod (Paris). 2008 Nov;37(7):691-6. doi: 10.1016/j.jgyn.2008.05.009. Epub 2008 Jul 7.
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.
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.
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.
The fetal fibronectine is probably useless in this context, given the additional cost and no improvement compared with the simple Bishop score.
我们研究的目的是确定与Bishop评分相比，胎儿纤维连接蛋白是否是引产成功的更好预测指标。
在我们科室进行了一项前瞻性观察性非随机研究，纳入了2000年10月至2004年6月计划引产的234例患者。通过采集宫颈内样本检测胎儿纤维连接蛋白，并使用Bishop评分评估宫颈状态。使用SPSS 12版软件通过Mantel-Haenzel卡方检验和Cox逐步多元回归分析数据。
对于所有纳入患者，胎儿纤维连接蛋白阳性预测引产24小时内阴道分娩的似然比为1.34（95%可信区间1.04-1.73，p=0.027），初产妇为1.51（95%可信区间1.00-2.33，p=0.048），Bishop评分为1.92（95%可信区间1.51-2.42，p=0.0001）。多元回归分析显示，与引产成功独立相关的唯一变量是Bishop评分、产次和患者年龄。未发现宫颈纤维连接蛋白的存在与剖宫产率之间有显著关联：纤维连接蛋白阳性组为21.84%，阴性组为21.78%。
鉴于额外的成本且与简单的Bishop评分相比并无改善，在此情况下胎儿纤维连接蛋白可能并无用处。
