胎儿纤维结合素和Bishop评分预测足月孕妇引产成功的比较研究

The Comparison of FFN with Bishop Score for Predicting Successful Labor Induction

通过较大样本比较胎儿纤维结合素（ＦＦＮ）和Ｂｉｓｈｏｐ评分对预测足月孕妇引产的意义。对象为产科有引产指征和择期引产的足月孕妇共１０５例。方法：引产当日行阴道内诊前常规准备，用生理盐水３ｍｌ冲洗宫颈外国滞留１０分，抽取冲洗后的盐水送检ＦＦＮ水平。临床检查得出Ｂｉｓｈｏｐ评分。结果：１０５例受试者中，剖宫产１３例，≤２４小时引产成功５８例，＞２４小时引产成功３４例。ＦＦＮ预测孕妇引产成功的特异性为９０％，敏感性为７７％，阳性和阴性预测值分别为８７％和８１％。Ｂｉｓｈｏｐ评分预测孕妇引产成功的相应指标为７２％、６８％、７９％和５９％。结论：胎儿纤维结合素作为独立的客观标志预测足月孕妇引产是否成功优于Ｂｉｓｈｏｐ评分。

Objective: To compare the fetal fibronectin (FFN) with Bishop score for the prediction of successful labor induction. Methods: Term pregnant woman undergoing labor induction had a sample from the cervicovaginal mucus tested with a blinded quantitative determination of the FFN concentration before the initiation of prostaglandin (positive≥120 ng/ml). The study population (105 cases) was devided into two groups: women delivering within 24 hours after initiation of prostaglandin and women giving birth >24 hours. Results: of the overall 105 subjects,58 women delivering within 24 hew after initiation of prostaglandin and 34 women giving birth >24 hours, 67 had positive and 38 had negative FFN results. Patients with a positive result had a lower cesarean section rate (10% vs 16%, P<0 .05) and higher successful labor induction rate within 24 hours (87% vs 19 %, P< 0. 05). Conclusion: The specificity, sensitivity, positive and negative accuracy rates of FFN was 90%,77%,87% and 81% respectively,better than the corresponding value of Bishop score (72%, 68%, 79% and 59%) for the prediction of successful labor induction.