Phosphorylated IGFBP-1 in predicting successful vaginal delivery in post-term pregnancy.

Katarzyna Kosinska-Kaczynska,Miroslaw Wielgos,Szymon Kozlowski,Iwona Szymusik,Robert Brawura-Biskupski-Samaha,Dorota Bomba-Opon,Piotr Wegrzyn,Katarzyna Bobrowska

doi:10.1007/s00404-014-3577-x

Katarzyna Kosinska-Kaczynska, Miroslaw Wielgos + Show 6 more

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https://doi.org/10.1007/s00404-014-3577-x

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Abstract

PurposeTo estimate whether phosphorylated IGFBP-1 (phIGFBP-1) in cervical secretion in term and post-term pregnancies can predict spontaneous onset of labor or vaginal delivery.MethodsA prospective cohort study of 167 women in singleton term and post-term pregnancies, was conducted at 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, between 2013 and 2014. phIGFBP-1 test (Actim Partus Medix Biochemica), ultrasound cervix assessment and Bishop score were analyzed in the study group. Spontaneous onset of labor was the primary and vaginal delivery was the secondary outcome.ResultsIn 32.5 % of patients, spontaneous uterine contractions appeared. 67.5 % of women delivered vaginally, 32.5 % had cesarean section. phIGFBP-1 test predicted spontaneous onset of labor (sensitivity 0.69, specificity of 0.42) and successful vaginal delivery (0.67, 0.48). In the prediction of spontaneous delivery onset ultrasound cervical assessment and phIBFBP-1 had comparable sensitivity and in the prediction of successful vaginal birth all three tests had comparable sensitivity. The time from preinduction to spontaneous onset of delivery was significantly shorter in women with positive phIGFBP-1 test (13.65 ± 6.7 vs 20.75 ± 2.6 h; p = 0.006).ConclusionA test for phIGFBP1 presence might be an additional tool for predicting both spontaneous onset of labor and successful vaginal delivery in post-term pregnancies.

Highlights

Insulin-like growth factors I and II (IGF I and II) are wellknown agents controlling cell and tissue growth and metabolism
Purpose To estimate whether phosphorylated Insulin-like growth factor binding protein-1 (IGFBP-1) in cervical secretion in term and post-term pregnancies can predict spontaneous onset of labor or vaginal delivery
The aim of the study was to estimate whether insulinlike growth factor binding protein-1 (IGFBP-1) presence evaluation in cervical secretion in term and post-term pregnancies can predict spontaneous onset of labor or successful vaginal delivery in induced labors in comparison to ultrasound cervical length measurement and Bishop score

Summary

Introduction

Insulin-like growth factors I and II (IGF I and II) are wellknown agents controlling cell and tissue growth and metabolism. In pregnant women’s serum the concentration of IGFBP-1 increases during gestation [3] It is the major protein of the amniotic fluid [7]. As the cervix matures and the labor approaches, the chorion and decidua detach and phosphorylated IGFBP-1 (phIGFBP-1) gets into the cervical secretion, its presence reflects decidual activation and dilatation of the internal os. Kekki et al reported that phIGFBP-1 presence in cervical secretion is a predictor of preterm delivery [8]. This relationship was confirmed by other authors [9,10,11,12,13,14,15].

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