Department of Obstetrics and Gynecology, University A. Avogadro, Via Solaroli 17, 28100 Novara, Italy.
Arch Gynecol Obstet. 2012 Nov;286(5):1123-9. doi: 10.1007/s00404-012-2432-1. Epub 2012 Jun 24.
The aim of this multicentric study is to compare clinical, biophysical and molecular parameters in the prediction of the success of labour induction with prostaglandins.
We included 115 women, who underwent to labour induction at term with vaginal prostaglandin gel. We evaluated the diagnostic efficiency of endocervical phosphorylated insulin-like growth factor-binding protein (phIGFBP-1), cervicovaginal interleukins 6 (IL-6) and 8 (IL-8). We analyzed the transvaginal sonographic measurement of cervical length. A receiver-operating characteristics (ROC) curve was used to determine the most useful cut-off point. A multivariate logistic regression model was used to analyze the combination of significant predictive variables following univariate analysis. We analyzed all the data searching for the parameters that best predict the beginning of the active phase of labour within 12 h.
36.5 % of the patients delivered within 12 h. The Bishop score was >4 in the 43 % of patients with an active phase. The best cut-off values at ROC curves for cervical length, IL-6 and IL-8 were respectively 22 mm, 5 mg/dl and 20,237 mg/dl. At univariate analysis, all predictors of success, with the exception of IL-6, were significantly associated with the beginning of the active phase. Multivariate analysis of the Bishop score (OR 2.3), phIGFBP-1 test (OR 11.2) and IL-8 (OR 6.6) showed that the variables were independent and therefore useful in combination to predict the success of labour induction.
The phIGFBP-1 test is a fast and easy test that can be used with Bishop score and IL-8 to reach an high positive predictive value in the prediction of the success of labour induction with prostaglandins.
本多中心研究旨在比较临床、生物物理和分子参数在预测前列腺素引产成功中的作用。
我们纳入了 115 名足月行阴道前列腺素凝胶引产的妇女。我们评估了宫颈内磷酸化胰岛素样生长因子结合蛋白（phIGFBP-1）、宫颈阴道白细胞介素 6（IL-6）和 8（IL-8）的诊断效率。我们分析了经阴道超声测量宫颈长度。使用受试者工作特征（ROC）曲线确定最有用的截断值。使用多变量逻辑回归模型分析单变量分析后有意义的预测变量的组合。我们分析了所有数据，以寻找在 12 小时内最佳预测分娩活跃期开始的参数。
36.5%的患者在 12 小时内分娩。Bishop 评分>4 的患者中有 43%处于活跃期。ROC 曲线中宫颈长度、IL-6 和 IL-8 的最佳截断值分别为 22mm、5mg/dl 和 20237mg/dl。单变量分析显示，除 IL-6 外，所有预测成功的指标均与活跃期的开始显著相关。Bishop 评分（OR 2.3）、phIGFBP-1 试验（OR 11.2）和 IL-8（OR 6.6）的多变量分析显示，这些变量是独立的，因此联合使用有助于预测前列腺素引产的成功。
phIGFBP-1 试验是一种快速简便的试验，可与 Bishop 评分和 IL-8 联合使用，以提高前列腺素引产成功预测的阳性预测值。
