| Background Gestation at 41 week without spontaneous delivery is a problem that should be dealt immediately not only by pregnancy women but also by doctors of Obstetrics and Gynecology. Even 41 weeks gestation is not pregnancy prolongation, but the perinatal mortality rate of is higher in partus after 41 weeks gestation than in due partus. Two different methods were applied in two groups of 466 cases of gestation for more than 41 weeks but without complications in one center. Among them, induced labor was applied immediately in 265 cases, but spontaneous labor was waited in another 173 cases, the results showed that there were significant differences in the mortality rate and the morbidity rate between the tow groups. The results of several researches showed that placenta starts aging from 38 or 39 weeks gestation, and the phenomena increases gradually, although the placenta has some spare capability at this stage, the fetal risk of intrauterme apnea increases. Some researches reported that the placenta stop growing after 41 weeks gestation. The contamination rate of fetal feces increases and the volume of amniotic fluid decreases. The rate of intrauterine respiratory distress of fetus and the rate of perinatal mortality increases. That means that it's very important to manage 41 weeks gestation correctly. Those management methods include some measures of induced labor. And some methods, such as Bishop score, cervical ultrasonic measure, fetal fibronectin, interleukin-6 and interleukin -8, have been applying to predict if induced labor would be successful. But subjective factors and present technique levels result in such problems as different test consequences, complex protocol and low repetitions. Therefore one simple,5rapid and efficient method is needed clinically for indication of labor.At present insulin like growth factor binding protein-1 (IGFBP-1) is used as indication for preterm labor. Researches results showed that the possibility of preterm labor raised as phosphorylated IGFBP-1 was detected hi cervical secretions. That is a reliable method of biochemical technique applied for indication of preterm labor. IGFBP-1 is secreted by decidual membrane cells and maternal-fetal liver. At the middle and late stage of gestation, IGFBP-1 presents as highly phosphorylated isoforms in the maternal serum and decidual membrane tissues, but mainly as low phosphorylated and dephosphorylated isoforms in amniotic fluid IGFBP-1 leaks out of decidual membrane cells into cervix and vagina due to mechanic pressure exerted by uterine contraction, proteolysis and regional inflammation separation of chorionic-decidua ,And that can be detected by indicator paper for labor. But application of IGFBP-1 in indication of induced labor for 41 weeks gestation is rarely reported in study documents. Objective1. To investigate if quantitative measure of IGFBP-1 in cervical secretions can be used as indication for timing of induced labor for 41 weeks gestation.2. To investigate if quantitative measure of IGFBP-1 in cervical secretions can be used to judge the cervical ripping.MethodsSeventy-four pregnancy women in 41 to 41+6 weeks gestation with index and no contradiction to induced labor were selected for the study, all those patients of primary parturition, cephalic presentation, single fetus, without membrane rupture, without uterine contraction, without intercourse history in 72 hours and serious pregnant complications.6Quantitative reagent kit of IGFBP-1 was produced by Shanghai Boya Co. Samples of cervical secretions were collected by asepsis woolen smear and tested by indicator paper. The result was recorded as positive as two blue lines appeared on the paper in 5 minutes, the result was recorded as negative as only line appeared on the paper.Test results of labor indicator reagent, the time elapsed from sample taking to successful induced labor and Bishop scores at samples taking were observed and recorded. The patients were divided in IGFBP-1 positive and IGFBP-1 negative groups according to test results, in...
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