Objective: We sought to evaluate whether the presence of a positive fetal fibronectin (≥50 ng/mL) in nulliparous women undergoing preinduction cervical ripening with the intracervical Foley catheter predicted vaginal birth. METHODS: This was a prospective blinded observational trial of nulliparous women undergoing preinduction cervical ripening. We excluded women who had a contraindication to vaginal birth. Cervical and vaginal fetal fibronectin specimens were obtained before preinduction cervical ripening with an intracervical Foley catheter. The managing obstetrician was blinded to these results. RESULTS: A total of 241 women met the inclusion criteria, of which 54.4%delivered vaginally. There was no difference in the rate of vaginal delivery among women with either a positive cervical fetal fibronectin (positive fetal fibronectin 55.8%compared with negative fetal fibronectin 53.3%, P = .70) or positive vaginal fetal fibronectin (positive fetal fibronectin 57.6%compared with negative fetal fibronectin 53.3%, P = .56). Women with a positive cervical fetal fibronectin did have a shorter duration of cervical ripening (fetal fibronectin-positive 229 ±220 minutes compared with fetal fibronectin-negative 379 ±193 minutes, P < .05),duration of oxytocin (fetal fibronectin-positive 655 ±555 minutes compared with fetal fi-bronectin-negative 731.5±342 minutes, P < .025) and required lower maximal doses of oxytocin (fetal fibronectin-positive 18.4 mlU/min compared with fetal fibronectin-negative 21.8 mlU/min, P = .005). Women with a positive vaginal fetal fibronectin demonstrated only a shorter duration of cervical ripening compared with their fetal fibronectin negative counterparts (fetal fibronectin-positive 300 ±216 minutes compared with fetal fibronectin-negative 345 ±201 mi- nutes, P < .05). CONCLUSION: Fetal fibronectin does not predict vaginal delivery in nulliparous women requiring preinduction cervical ripening.
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