We evaluated quantitative cervicovaginal foetal-fibronectin as a predictor of cervical ripening and labour duration in late-term pregnant women with an unfavourable cervix. This was an analytical cross-sectional study wherein 152 women, with late-term pregnancy and unfavourable cervix, at 41weeks3days gestational age, had pre-induction quantitative cervicovaginal foetal-fibronectin determined using ELISA. Data were compared in nulliparas and multiparas at a significance level < 0.05. The mean age of late-term pregnant women was 30.4 ± 4.3 years. Median cervicovaginal foetal-fibronectin levels in nulliparous and multiparous women were 45.35 ng/ml and 46.93 ng/ml respectively(p = 0.289). The correlation between foetal-fibronectin levels and cervical ripening duration was poor in nulliparous(r = 0.014) and multiparous(r = 0.024) women. The Youden's foetal-fibronectin cut-off level had a sensitivity of 53.5% and specificity of 71.6% in predicting cervical ripening duration of > 12 hours in late-term pregnancy with an area under the ROC curve of 0.634. Quantitative cervicovaginal foetal-fibronectin is a poor correlate and predictor of cervical ripening and induced labour duration in late-term pregnancy.IMPACT STATEMENT Cervicovaginal foetal fibronectin is useful in the prediction of preterm delivery but its role in prolonged pregnancy is unclear. Cervicovaginal foetal fibronectin is a poor correlate and predictor of cervical ripening and induced labour duration in late-term pregnancy Cervicovaginal fibronectin should not be used to predict ease and success of cervical ripening and induction of labour in women with late-term pregnancy.
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http://dx.doi.org/10.1080/01443615.2023.2204975 | DOI Listing |
J Pregnancy
December 2024
Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
Preinduction cervical ripening in previous caesarean pregnancy is limited to intracervical Foley catheter. This study is aimed at finding the vaginal birth rates, improvement of Bishop score, and safety of osmotic dilator (Dilapan-S) among women with previous caesarean pregnancy. We conducted this single-group clinical study after the approval of the institute ethics committee, clinical trial registration, and obtaining informed consent.
View Article and Find Full Text PDFEur J Obstet Gynecol Reprod Biol
December 2024
Dep. Obstetrics and Gynecology, Medical School, University of Lisbon, Portugal; CEAUL - Centro de Estatística e Aplicações, Faculdade de Ciências, Universidade de Lisboa, Portugal.
Objective: To evaluate whether the success rate of oral mifepristone was not inferior to that of Foley balloon catheter for outpatient cervical ripening of term pregnancies, and whether there were differences in side effects for mothers and newborns.
Design: Open-label, non-inferiority randomised controlled trial.
Setting: A tertiary care European university hospital in an urban setting.
Health Technol Assess
December 2024
Usher Institute, University of Edinburgh, Edinburgh, UK.
Background: Around one in three pregnant women undergoes induction of labour in the United Kingdom, usually preceded by in-hospital cervical ripening to soften and open the cervix.
Objectives: This study set out to determine whether cervical ripening at home is within an acceptable safety margin of cervical ripening in hospital, is effective, acceptable and cost-effective from both National Health Service and service user perspectives.
Design: The CHOICE study comprised a prospective multicentre observational cohort study using routinely collected data (CHOICE cohort), a process evaluation comprising a survey and nested case studies (qCHOICE) and a cost-effectiveness analysis.
Medicine (Baltimore)
December 2024
Department of Obstetrics and Gynecology, Taixing People's Hospital, Taixing, China.
The timing of amniotomy after the Foley balloon catheter removal is crucial for successful labor induction. This study aimed to assess the effects of the Bishop score on the timing of amniotomy in patients undergoing labor induction after the Foley balloon catheter removal. This was a retrospective cohort study based on electronic medical records.
View Article and Find Full Text PDFActa Obstet Gynecol Scand
December 2024
Department of Obstetrics and Gynecology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Introduction: Pre-labor rupture of membranes (PROM) occurs in about 8% of term pregnancies with over 70% delivering spontaneously within 24 h. However, prolonged PROM increases the risk of chorioamnionitis and neonatal sepsis. While misoprostol and oxytocin are considered safe and effective methods of labor induction, most guidelines do not encourage balloon catheter (BC) use following PROM given concerns about increased risk of chorioamnionitis.
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