胎儿纤连蛋白在足月妊娠引产中的预测价值  

Fetal fibronectin as a predictor for a successful induction of labour at term

作　　者：刘海意[1] 曾友玲[1] 曾万江[1] 乔福元[1] 龚洵[1] 吴媛媛[1] 

机构地区：[1]湖北省武汉市同济医院妇产科,湖北武汉430030

出　　处：《中国现代医学杂志》2009年第18期2855-2857,2860,共4页China Journal of Modern Medicine

摘　　要：目的探讨宫颈阴道分泌物中胎儿纤连蛋白(fetalfibronectin,FFN)的检测结果在预测足月妊娠引产效果以及分娩方式中的应用价值。方法前瞻性观察37例孕足月、需要并同意引产的患者,在引产前进行宫颈分泌物FFN检测并根据结果分为阳性和阴性两组,均选用普贝生引产,分别记录宫颈Bishop评分、分娩发动时间以及分娩方式。结果37例中FFN阳性组25例,阴性组12例,使用普贝生促宫颈成熟有效率分别为88.00%和58.33%,引产成功率80.00%和33.33%,阴道分娩率68.00%和25.00%,两组间差异具有显著性。FFN预测引产成功的敏感性为83.30%,特异性为61.54%,阳性预测值为80.00%,阴性预测值为66.70%,预测结果优于宫颈Bishop评分。结论胎儿纤连蛋白是反映宫颈成熟度的良好标志,对足月妊娠的分娩发动有一定的预测价值,且预测价值优于宫颈Bishop评分;进一步的大样本研究将有助于合理选择足月妊娠引产时机、降低剖宫产率。[ Objective ] To investigate the application value of fetal fibronectin（FFN） qualitative test in the cervicovaginal secretions in predictive of successful induction of labour at term. [ Methods ] The study enrolled prospectively 37 women undergoing labor induction at term. Fetal fibroneetin was first assayed with eervicovaginal secretions on the day before induction of labor. Digital cervical evaluation were underwent to get Bishop score. Induction of la- bor was performed with propess. [ Results ] For the 25 cases with positive fetal fibronectin, the success of preinduetion cervical ripening was 88% and the success of inductiforon of labor of was 80% and the success of vinginal delivery was 68%, while for the 12 cases with negative fetal fibronectin, the success of inductiforon of labor of was 33.33% and the success of vinginal delivery was 25% （P 〈0.05）. The sensitivity of FFN for success of inductiforon of labor was 83.3%, specificity 61.54%, positive predictive value 80%, negative predictive value 66.7%. The results were better than. that of Bishop score. [ Conclusion] Fetal fibronectin is a good marker for cervical maturity. It is more accurate and objective than Bishop score. Qualitative test of FFN with cervicovaginal samples can be used to predict accurately the outcome of induced labor at term. Further research with larger samples will contribute to select right opportunity for induction of term labor, and reduce the rate of cesarean section.

关 键 词：胎儿纤连蛋白 足月妊娠 引产 BISHOP评分 分娩预测 

分 类 号：R719.3[医药卫生—妇产科学]