Evaluating cervical mucous inflammatory status as novel predictor for spontaneous onset of labour at term: A prospective observational study

Abstract

BackgroundThe objective of this study was to explore the relationship between cervical inflammatory status at term gestation and spontaneous onset of labour. The aim was to search for a cost-effective, readily available, point of care test as predictor for spontaneous onset of labour (SPOL) at term. MethodsThis prospective observational cohort study was ICMR-STS project. Women who were primigravida with 20–30 years age, term gestation, single-live foetus with cephalic presentation, not in labour, asymptomatic with no evidence of infection and obstetric complications, were included in the study. Cervical mucous samples were subjected to cytological assessment after Giemsa staining and differential count under microscope. Primary outcome measure was the spontaneous onset of labour within 7 days of enrollment; and depending on whether SPOL occurred or not the participants were divided into two groups, Group I and Group II, respectively. ResultsOut of 47 participants, 23 went into SPOL and included in Group I. We observed significantly increased mean levels of polymorphs (71.7 ± 29 vs. 55 ± 28; p-value 0.03), and raised PLR (12.72 ± 6.89 vs. 7.01 ± 3.4; p-value 0.0007) in group I before onset of labour. Polymorphs showed good sensitivity (73.9%) and specificity (83.3%); and on ROC polymorphs curve was on the left of the reference line which indicated that it has good predictive value for SPOL. ConclusionPredominance of polymorphs in the cervical mucous prior to the onset of labour has emerged as a novel, cost-effective, point of care predictor for SPOL.