Effect Prediction Of Cervical Vaginal Secretion's Fetal Fibronectin On Indouction Of Term Prenency By Propess

OBJECTIVETo study the effect of fetal fibronectin in cervicovaginal secretions on induction of term pregnancy by propess.METHODS41single term pregnant woman with proper fetal position,age≤35years old, pregnancy of 40—41weeks,without premature rupture of membrane and obvious cephalopelvic disproportion and irregular uterine contraction.NST normal,amniotic fluid volume are normal,without sexual intercourse during the past three days,have indications of induction and no maternal and infantile contraindications. Determination the fFN of cervical vaginal secretions before use propess,then,for cervical Bishop score,the Bishop score≤6points's,placing a propess in posterior fornix.Test procedure of fFNExposed cervical by speculum,cervicovaginal secretions are obtained from the posterior fornix of the vagina by a sterile polyester tipped applicator.the collection process is intened to be gentle.lightly rotate the applicator tip across the posterior fornix of the vaginal for approximately 10-15 seconds,then remove the applicator and insert the tip into the tube containing the extraction buffer and mix vigorously for 10 to 15seconds.rolling the tip against the inside of the tube to mixed it adequate,discard the applicator.put out the test strip and insert the lower end of the test strip into the tube containing the extraction buffer for 10minutes,remove the test strip and read the result.A negative result indicating the absence of fetal fibronectin will appear as one line,A positive result indicating the presence of fetal fibronectin will appear as two lines.RESUT①average time of in labor the interval from using of propess to irregular uterine contraction:fFN positive group have 20subjects,The shortest time of in labor is 3.2hours,the longest is 10.8hours,the average time is 6.3hours;fFN negative group have 21subjects,The shortest time of in labor is 5.3hours,the longest is 24hours(uterine contraction is not initiated are calculated as 24hours,a total of four cases),the average time are 9.7hours.the comparison of the two groups had markedly difference.t=-3.157,P<0.01.②rate of in labor the sign of in labor is gradually enhanced uterine contraction, sustained 30seconds or more,intermittent 5-6minutes,accompanied by progressive cervical canal disappeared,Dilatation and decline of fetal presentation.the positive group have 20cases,they are all in labor,the indence of in labor is 100%.the negative group have 21cases,only 17cases are in labor,the rate is 80.95%,The comparison of the two group had no statistical significanc.P>0.05.③incidence of fetal heart rate(FHR)changes FHR change means that after onset of labor,the FHR is less than 120bpm or more than 160bpm,by given left recumbent position,inhaust oxygen and intravenous glucose and vitamin C,after half an hour still no improvement.There are 9cases occurred with FHR changes in fFN positive group and only 3cases in negative group.The comparison of the two groups had markedly difference,χ~2=4.668,P<0.05.④vaginal birth rate fFN positive group have 20cases,among them,11cases are vaginal birth.9cases are cesarean section(9cases are all because of fetal distress),the ratio is 55%,fFN negaitive group have 21cases,among them,13cases are vaginal birth,8cases are cesarean section(3cases are because of fetal distress,4 cases are social factor,anthour is head position abnormal),the ratio is 61.9%.The comparison of the two group had no statistical significanc.χ~2=0.201,P>0.5.CONLUSIONin using of propess to induce labor of term pregnant women whom cervical Bishop score≤6 points,the fFN positive group had shorter time of in labor and higher rate of in labor,but the incidence of FHR changes is also higher,the fFN negative group had lower rate of in labor,but it is relatively safe,Due to the limited sample size,the conclusions required further study.