Prediction of cervical response to prostaglandin E2 using fetal fibronectin

Background: To determine whether presence of fetal fibronectin in cervico-vaginal secretions at term will predict the cervical response to prostaglandin E-2 (PGE(2)) pessaries and successful induction of labor amongst subjects with unfavorable cervices. Method's. Cervico-vaginal secretion was tested for the presence of fetal fibronectin prior to cervical ripening with PGE(2) pessaries in women with a singleton term or post-term pregnancy undergoing induction of labor. The total number of PGE(2) pessaries, interval from induction to labor and induction to delivery, latent phase and active phase of labor and cesarean section rate were compared. Results. Women with fetal fibronectin in their cervico-vaginal secretion had better cervical response to PGE(2) pessaries and required fewer doses for induction of labor and they took a shorter time interval from induction to delivery. They tend to have a lower cesarean section rate but the figures did not reach statistical significance. Conclusions. The presence of fetal fibronectin from cervico-vaginal secretions in subjects with a Bishop score <5 is predictive of a favorable response to induction by prostaglandin pessary.