ROLE OF PHOSPHORYLATED INSULIN-LIKE GROWTH FACTOR BINDING PROTEIN-1 AS PREDICTOR OF SUCCESSFUL LABOR INDUCTION IN FULL TERM PREGNANCY - A CROSS SECTIONAL STUDY

Abstract

BACKGROUND: Induction of labor is the artificial initiation of uterine contractions before its spontaneous onset to deliver the feto-placental unit. Induction of labor is one of the most important part of obstetrics, as we can interfere and induce labor as a lifesaving procedure for mother or fetus or both. The frequency of inducing labor to reduce the gestational period due to various indications has increased. Hence pre induction biomarkers are necessary to predict the successful induction of labor and mode of delivery. In this study Phosphorylated Insulin like growth factor binding protein 1 (phIGFBP-1), an emerging pre-induction biomarker is used to predict the successful labor induction. AIM: To detect the presence of Phosphorylated insulin-like growth factor-binding protein-1 (phIGFBP-1) in patients undergoing induction of labor using Actim partus test and to evaluate the presence of Phosphorylated insulin-like growth factor-binding protein-1 (phIGFBP-1) among the patients with and without successful induction of labor. MATERIALS & METHODS: All the consenting eligible pregnant women who were hospitalized to the labor room were recruited for the study. Cervicovaginal swab from the women who are undergoing labor induction is taken and tested for presence Insulin-like growth factor binding protein 1 (IGFBP1), using Actim partus test. Then assessment will be made about mode of delivery in patients with and without phosphorylated insulin like growth factor binding protein 1 positive. RESULTS: This study included 58 pregnant women who were over 37 weeks pregnant and were scheduled for induction. The findings showed that approximately half were primigravida mothers, followed by gravida 2 (29.3%) and 3 (22.4%). Most of the patients had a gestational age of more than 40 weeks (50%). Foleys's + Misoprostol + Oxytocin was the most common induction method used (32.8%), followed by Foleys's +Misoprostol (22.4%) and misoprostol xx

only (22.4%). Most of the patients had a vaginal delivery (77.6%), while 22.4% had LSCS. Overall, the labor induction was successful among 93.1% of pregnant women. In this study, the Actim partus test was positive in 79% of the cases. Most pregnant women scored a BISHOP score of 5 and above (70.7%), whereas 29.3% scored lower than 5. The presence of phIGFBP-1 in the cervicovaginal fluid is identified as a significant factor in predicting labor. The sensitivity, specificity, PPV, NPV, and accuracy of the phIGFBP-1 in predicting successful labor induction were 85.2%, 100%, 100%, 33.3%, and 86.2%, respectively.