임신중 고혈압성 질환의 임상적 고찰

김주욱(JW Kim),원광연(KY Won),조재동(JD Cho),김성도(SD Kim),안재영(JY Ahn) 대한산부인과학회 1985 Obstetrics & Gynecology Science Vol.28 No.6

A clinical study was undertaken on 631 cases of hypertensive disorders in pregnancy who were admitted to Korean General Hospital for the period of 10 years from Jan. 1973 to Dec. 1982, during which time, there were 11,307 deliveries in total. The results were as follows: 1) The incidence of hypertensive disorders in pregnancy was 5.6% of total deliveries. 2) The ratio of mild preeclampsia was 54.5%; severe preeclampsia, 40.9%; eclampsia, 3.3%; chronic hypertensive vascular disease with toxemia, 0.6%; chronic hypertensive vascular diseases without toxemia, 0.5%; and unclassfied, 0.2%, respectively. 3) The frequency of disease was higher in the age group above 40 years old and below 19 years old age. 4) According to parity, the higher frequency was noted in primipara and grand multipara of 4 or above. 5) Among four seasons, the disease was more frequently seen in spring time. 6) The incidence of hypertensive disorders in twin pregnancy was 21.8%, which is about four times higher than overall incidence. 7) The disease was more prevalent in women who did not take antenatal care. 8) Average fetal weight was lower than those born in normal mothers. 9) Among the associated diseases, twin pregnancy was 17 cases, abruptio placentae 9 cases and essential hypertention 7 cases. 10) Average hemoglobin level was 11.7gm% which revealed 0.7gm% higher than that of normal mothers.

한국불임여성에 있어서 자궁난관조영술의 임상적 고찰

곽현모(HM Kwak),김성도(SD Kim),이영호(HY Lee),오기석(KS Oh) 대한산부인과학회 1974 Obstetrics & Gynecology Science Vol.17 No.6

1967년 1월부터 1969년 12월까지 만 3년간 불임을 주소로 연세대학교 의과대학 산부인과 외 래에 내원하여 자궁난관조영술을 시행한 예 중 임상 및 X선 기록이 충실한 200예를 대상으 로 분석 고찰하여 다음과 같은 결론을 얻었다. 1) 자궁난관조영술을 시행한 200예 중 원발성불임은 121예, 속발성불임은 79예였다. 2) 연령분포를 보면 원발성불임군에는 25∼29세군이 58예(47.9%), 속발성불임군에서는 30∼ 34세군이 31예(39.3%)로 가장 많았다. 3) 불임기간은 월발성 및 속발성 불임 전체에서 불임 기간 7∼9년이 60예(30.0%)로 가장 많 았고, 속발성불임군에서 원발성불임군에 비해 불임기간이 다소 긴 경향을 볼 수 있었다. 4) 기왕력에 있어서 골반염증성 질환이 22예(11.0%)로 가장 많았으며 원발성불임군에서는 진단목적으로 소파수술을 받은 예가 11에, 충수절제술이 7예였고 속발성불임군에서는 최종 임신을 임신중절술로 마친 예가 25예(12.5%)로 가장 많았다. 5) 자궁상은 정상이 125예(62.5%)이고 비정상 70예 중 내강벽 불규칙상이 30예(15.0%)로 가 장 많았다. 6) 난관상에서는 팽대부 및 체부의 난관수종상이 76예(38.0%)로 가장 높은 빈도를 나타냈 다. 7) 양측난관폐쇄는 52.0%(104예)이였으며 편측폐쇄가 16.0%(32예)로 좌우측난관에서 의의있 는 차이는 없었다. 8) 난관의 폐쇄부위는 각부 30예, 협부 32예 그리고 팽대부가 71예(35.5%)로 가장 많았으며 좌우측 난관에서 차이는 없었다. 9) 복강상은 96예(48.0%)에서 출현하였다. 10) 골반내맥관상의 출현빈도는 13.5%로 타 보고자보다 높은치를 보였으며 원발성 및 속발 성에서 의의있는 차이는 없다. 11) 자궁, 난관, 복강상에 있어서 이들 전부가 정상인 것은 42예(21.0%), 하나 이상에서 비정 상인 것은 116예(58.0%)이였다. Hysterosalpingography has been universally accepted and approved method as a valuable aid in the diagnosis and treatment of infertility and tubal pathology, especially for tubal patency. A clinical analysis has been made on 200 cases of known infertile patients by the view of hysterosalpingogrm. The results were as follows : 1) In 200 cases of infertility, 121 cases were primary and remaining 79 cases were secondary infertility. 2) Age distribution showed the peak at 25-29 year old group in primary infertility and at 30-34 year old group in secondary infertility, cases of which were 58(47.9%) and 31(39.3%) respectively. 3) 60 cases of this study shows 7-9 years of duration infertility and it was longer in secondary than primary infertility. 4) In past history, pelvic inflammatory diseases were found in 22 cases (11.0%), diagnostic D & C in 25 cases (12.5%) of secondary infertility. 5) Uterine shadow revealed 125 cases of normal finding and 30 cases of irregular uterine cavity shadow, which was 15.0% and predominant abnormal finding. 6) Tubal pathology was predominent lesion in hysterosalpingogrm and bilateral occlusion was noted in 104 cases(52.0%) and unilateraltubal occlusion was 32 cases(16.0%).Tthere was no significant difference between right and left side. 7) In shape of tubes, hysterosalpinx of ampuaalr and fimbrial portion was predominant to the exclusion of patent tubes and cornual obstruction. 8) Sites of tubal occlusion were cornual in 30 cases, isthmic in 32 cases and ampullar and fimbrial portion in 71 cases. 9) Intravasation, one of complications of HSG was noted in pelvic cavity of 27 cases among 200 cases, which was 13.5%. 10) Abdominal despersion of radiopaque material appeared in 96 cases(48.0%) of this study and most common appearance was homogeneous hazzy cloudy shape. 11) Normal hysterosalpingogrm was noted in 42 cases(21.0%) and 116 cases(58.0%) was abnormal in one or more among uterine, tubal, and intraabdominal shadow.

경구피임제 오이기논 이. 디 ( Eugynone E.D ) 에 대한 임상적 연구

곽현모(HM Kwak),권병희(BH Kwun),김성도(SD Kim) 대한산부인과학회 1971 Obstetrics & Gynecology Science Vol.14 No.9

1968년 12월부터 18개월간 연세대학교 의과대학 산부인과에서 28정인 Eugynone E.D.에 관한임상시험을 하여 다음과 같은 결론을 얻었다. 1. 전대상자는 327명으로서 총사용 월경주기는 2061주기였다. 2. 자녀생존수는 3-4명이 가장 많았다. 3. 인공유산의 경험은 전혀 없었던 사람이 110명으로 가장 많았고 1-2회의 경험자가 차위로 되어 있었다. 4. 교육정도는 전대상자중에서 12.5%가 전혀 교육을 받지 못하였고 87.5%가 국민학교이상의 교육을 받은 자이었다. 5. Eugynone E.D.복용자중에서 중단한 자는 327명중 30명이었다. 6. Eugynone E.D를 사용하여 임신한 사람은 하나도 없었다. 7. 이상의 결과를 종합하여 Eugynone E.D.를 피임목적으로 사용하여 그 효능이 100%이며 부작용도 경미함과 동시에 자연소실함을 재확인하였다. The Eugynone E.D. is an extremely low dose and provene oral contraceptives made available in a special 28 days pack by Schering A.G. We are now conducting a clinical study of Eugynone E.D. This is a result of the our experience of 3327 women registered in Family Planning Clinic in Yonsei University Hospital for period of 20 months. Material and Methods: All cases were selected among the patients registered in Family Planning Clinic of Yonsei University Hospital. A total of 327 women were selected for careful clinical appraisals. Ecah individual was questioned, interviewed and examined as to their subjective symptoms before and after the taken oral pill. The chief criteria for inclusion in the study were proved fertility and history of no obious illness that would preclude the use of a systemic medication. We admistered Eugynone E.D, instructing the patients to take every first pack is begun on day 1st of the menstruation bleeding rather than 5th day of menstruation, as has been the case with other methods, thus obtaining the need for counting. Tablets are taken continuously, one every day, without stopping. The patient who has missed a tablet, it is less that 36 hours since a tablet was last taken the patient should take the missed tablet as soon as possible. Result: 1) The 327 women who had Eugynone E.D. as of December, 1968, represented a total of 2067 patients-cycles. 2) The women age distribution showed that majority of patients were 30 to 39 year-old women. 3) The majority of number of living children was three to four. 4) Nausea: One of the side effects encountered with progestin products as contraceptives is nausea and other gastrointestinal complaints. Of 2067 cycles studies, nausea was noted only 1.46%. As most patient continued taking the medication despite the single episode or two of nausea, it must be concluded that it did not present a significant problem. Most instances of nausea were reported in either the first ro second cycle. 5) Bleeding: One of the major considerations in the cyclic use of progestins for contraception is the maintenance of a regular menstrual shcedule. There were 0.92% who had break through bleeding or intermenstrual bleeding. 6) Amenorrhea: The total per cent of missed period was 0.53% and hypomenorrhea was 5.24%. The menorrhagia was 1.36%. 7) Indigestion: The total of the complaining of the indigestion was 2.09%. 8) Body weight and headache: We encountered the body weight gain means that 5 Lbs or more gain during the taking the oral pill. The body weight gain was 0.6% and headache cocomplained patients were 0.92%. 9) Discontinue: The discontinued patients were 30 among the 327 patients. 10) Pregnancy: There was no unplanned pregnancy. 11) The side effects did not present a significant problem. Most incidence of nausea, bleeding occured in the early month of use and promptly disappeared.

자궁내 태아사망에 관한 임상적 고찰

박순홍(SH Park),박정원(JW Park),송혜섭(HS Song),김성도(SD Kim),안재영(JY Ahn) 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.8

1983년 1월 1일부터 1992년 12월 31일까지 만 10년간 서울고려병원 산부인과에서 입원하여 분만한 9,834예중 임신 20주이후에 태아의 체중이 500 gm이상인 자궁내 태아사망 101예의 임상기록을 기초로 관찰분석하여 다음과 같은 결론을 얻었다. 1. 산전관리를 한번도 받지않은 경우는 50.5%였다. 2. 자궁내 태아사망의 발생빈도는 1.08%였다. 3. 연령분포는 21세에서 48세까지의 분포를 보였으며 그중 26-30세군이 53.5%로 가장 많았다. 4. 출산력은 초임부가 57.5%로 가장 많았고, 1회분만이 27.7%이었다. 5. 자궁내 태아사망의 기왕력이 있었던 경우는 3예(2.9%)였으며, 자연유산의 기왕력은 14예(13.8%)였다. 6. 자궁내 태아사망의 임신주수별 분포는 임신 20-24주에서 35.7%로 가장 많았다. 7. 태위는 두위가 76.4%로 가장 많았고, 남아와 여아의 비는 1.24:1이며 태아체중이 2,500 gm미만인 경우는 71.5%였다. 8. 사망태아의 분만방법은 유도분만이 53.5%로 가장 많았고, 개복수술이 25.7%, 자연분만이 20.8%였으며, 개복수술의 적응증은 유도분만의 실패, 제왕절개술의 기왕력, 자궁파열, 전치태반 및 태반조기박리 순이었다. 9. 자궁내 태아사망의 원인은 원인불명이 40.9%, 임신중독증 18.9%, 전치태반 8.9%, 제대합병증 6.9%이며, 태반조기박리 5.9%, 융모양막염 4.9%, 자궁파열 4.9%, 모체질환 3.9%, 선천성기형 2.9%, 매독 1.9%순이었다. 10. 자궁내 태아사망의 모성합병증은 20.8%을 나타냈고 이중 출혈이 42.9%로 가장 많았고 그외 자궁경부파열(20.8%), 발열(19.7%), 창상감염(14.2%)순이었다. 11. 자궁내 태아사망과 DIC와의 관계는 혈소판이 10만/mm^3으로 감소한 경우는 12.5%, 섬유소원이 150 mg/dl이하인 경우는 4.8%, FDPs가 40 micro g/ml이상인 경우는 10.9%, Partial thromboplastin time이 50초 이상 연장된 경우는 1.7%였으며, prothrombin time이 14초이상 연장된 경우는 없었다. 12. 산모의 혈액형이 A형 Rh양성이 35.7%로 가장 많았다. The intrauterine fetal death is defined as the intrauterine death after 20 weeks gestation or attainment of more than 500 gm body weight prior to the complete expulsion or extraction from its mother. This is a clinical analysis of 101 cases of the intrauterine fetal death among 9834 deliveries of Seoul Koryo General Hospital during 10 years period from Jan, 1983 to Dec, 1992. The results of this study are as follows: 1. The 50.5%of the cases had not received any antenatal care. 2. The incidence of the intrauterine fetal eath was 1.08%. 3. The age distribution of mothers with the intrauterine fetal death was between 21 to 48 years and was highest in the 26-30 years range(53.5%). 4. As for the parity distribution of mothers with intrauterine fetal death, the nulliparous group(57.5%) was most common and the next group was para-1(27.7%). 5. There were 3 cases(2.9%) with previous history of the intrauterine fetal death and 14 cases (13.8%) with the previous history of the spontaneous abortion. 6. The most common gestational weeks when intrauterine fetal death was detected was 20 to 24 weeks gestational period(35.7%). 7. The most common presentation was cephalic(76.4%) and the sex ratio of male verus female was 1.24:1, and the 71.%% of dead fetus weighted less than 2500 gm. 8. The mode of delivery for the intrauterine fetal death showed that the induction of labor was most common(53.5%) and the laparotomy was 25.7% and the spontaneous delivery was 20.8%. The most common indication of laparotomy was the failure of induced labor and the others were the previous cesarean section status, the uterine rupture, placenta previa and placenta abruption,in that order. 9. The most common cause of intrauterine fetal death was unexplained cases(40.9%) and the others were preeclampsia(18.9%), placenta previa(8.9%), cord complcations(6.9%), placenta abruption(5.9%), chorioamnionitis(4.9%), uterine rupture(4.9%), maternal illness(3.9%), congenital anomaly(2.9%) and syphils(1.9%), in that orders. 10. The incidence of maternal complication was 20.8% and the most common complication was hemorrage (42.9%), and the others were cervical laceration(23.8%), fever(19.1%), wound infection(14.2%), in that orders. 11. The DIC studies of intrauterine fetal death were as follows: the platelet count was decreased below the level of 100,000/mm^3 in 12.5% of the cases, the fibrinogen levels were decreased below the level of 150 m/dl in 4.8% of the cases, the FDPs were increased above the levels of 40 micro g/ml in 10.9% of the cases, the partial thromboplastin time was prolonged above 50 sec in 1.7% of the cases and the prothrombin time was not prolonged above 14 sec. in any case. 12. The most common blood type was Rh positive A type(35.7%).

자궁경관 임신의 보존요법후 성공적인 임신 1 예

이기호(KH Lee),임대성(DS Lim),신수재(SJ Shin),김성도(SD Kim),안재영(JY Ahn) 대한산부인과학회 1989 Obstetrics & Gynecology Science Vol.32 No.1

본 증례는 33세경산부가 불완전 유산이라는 진단하에 소파수술을 받던중 대출혈을 일으켜 본원으로 이송되어 초음파를 이용 자궁경관임신으로 진단한후 보존요법의 하나인 자궁경부 결찰과 함께 질폐색을 시도하여 치료에 성공한 후 임신되어 남아를 분만한 경우로 다음에 임신을 원하는 경우에는 우선 일차적으로 보존요법을 시행해 보는 것이 바람직하다고 생각 되어 진다. Cervical pregnancy is a rare form of ectopic gestation in which the ovum implants within the cervix below the internal os. The exact cause of the cervical pregnancy is not known, however permanent injury to the uterine mucosa is suspected . Because of uncontrolled profuse painless vaginal bleeding total hysterectomy is mostly perfomred in the management of cervical pregnancy . We present a case of cervical pregnancy in 33years old mulipara who delivery a healthy male infant after conservative treatment , and literatures on the cervical pregnancy were briefly reviewed.

Prostaglandin F₂α의 양막외주입에 의한 중기임신중절

신수재(SJ Shin),정승균(SK Chung),한치동(CD Han),김성도(SD Kim),안재영(JY Ahn) 대한산부인과학회 1984 Obstetrics & Gynecology Science Vol.27 No.6

Although much research is being carried out all over the world, midtrimester abortion still presents many difficult medical problem. It is well known that prostaglandin E and F are effective in uterine contraction in both pregnant and nonpregnant uterus. The use of prostaglandin F₂α administered by extraamniotic infusion through Foley catheter for the induction of abortion was studied in 35 patients between 17 and 33 weeks gestation, and this method had been proved to be safe and effective mean of the termination of the pregnancies at midtrimester. The results were as followings: 1. The range of age was between 24 and 42. 2. Nulliparas were 17 cases and multiparas were 18 cases. 3. Intrauterine fetal death were indicated in over the half. 4. The mean duration from infusion to the delivery of the fetus was 15.70 hours. The mean duration for the multiparas was 14.17 hours, and the mean duration for the primipara was 15.25 hours. 5. The mean total dosage of prostaglandin F₂α was 5.692mg in primiparas and 4.479mg in multiparas. 6. The abortion was successfully induced in 88.2% of primiparas and 88.9% of multiparas within 24 hours. 7. The successful abortion rate by the balloon size of the Foley catheter were 86.4% in the group of 30~40cc balloon size and 100% in the group of 80~100cc balloon size within 24 hours. 8. The duration of the oxytocin infusion after the expulsion of Foley catheter were 4.59 hours in the group of 30~40cc balloon size and 1.32 hours in the group of 80~ 100cc balloon size. 9. The most common side effect was consisted of gastrointestinal symptom such as nausea, vomiting and diarrhea. Other side effects were included transient pyrexia, chilling and facial flush. 10. The main complication in this series was incomplete abortion, which occurred in 6 patients. Others were excessive bleeding over 500ml, endometritis and cervical laceration.

난소임신 2예

한치동(CD Han),신수재(SJ Shin),정승균(SK Chung),김성도(SD Kim),안재영(JY Ahn) 대한산부인과학회 1984 Obstetrics & Gynecology Science Vol.27 No.3

Primary ovarian pregnancy is comparatively rare in ectopic pregnancy and the Spiegelberg`s criteria should be fulfiled for the diagnosis of ovarian pregnancy. Thw cases of ovarian pregnancy were seen in recent years at Korea General Hospital and presented with a brief literature.

자간전증 산모에서 증가된 혈장 호모시스테인의 위험인자로서의 임상적 유용성 연구

김성도,한종설,송혜섭,이교원,김범영,최익준,신봉식,장우섭,조현구 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.10

목적: 자간전증이 있는 미산부에서 혈중 호모시스테인 농도가 증가하는지를 조사하여 혈중 호모시스테인이 자간전증에서 위험인자로서의 임상적 유용성이 있는가에 대하여 연구하였다. 연구 방법: 1997년 10월부터 1998년 4월까지 강북 삼성병원 산부인과에 분만을 위해 입원한 미산부중 자간전증이 있었던 미산부 20명(중증: 9명, 경증: 11명; 20명 중 13명: 조기발병 자간전증미산부)을 환자군으로 정하고 자간전증이 없었던 미산부 20명을 대조군으로 선정하여 이들 40명 모두의 혈액을 채취한 다음 high performance liquid chromatography로 혈장 총호모시스테인 농도를 측정하였고, 방사선면역측정법으로 엽산과 비타민 B12 농도를 측정하였다. 결과: 자간전증이 있었던 미산부에서 호모시스테인 농도는 12.61±3.06 μmol/L로서 자간전증이 없었던 정상 미산부에서의 6.63±1.72 μmol/L보다 통계적으로 유의하게 높았고(p<0.05), 조기에 자간전증이 발병했던 13명의 미산부에서 호모시스테인 농도는 12.71±3.41 μmol/L로서 자간전증이 없었던 정상 미산부에서의 6.63±1.72 μmol/L보다 통계적으로 유의하게 높았다(p<0.05). 엽산의 경우 환자군에서 6.86±2.96 nmol/L로서 대조군에서의 8.17±3.26 nmol/L와 통계적으로 유의한 차이가 없었으며, 비타민 B12 경우에도 환자군에서 237.8±73.1 pmol/L로서 대조군의 277.4±68.9 pmol/L와 통계적으로 유의한 차이가 없었다. 환자군에서 혈중 호모시스테인 농도가 중증군에서 13.79±3.23 μmol/L, 경증군에서 11.65±2.68 μmol/L로 두 군간에 통계적으로 유의한 차이가 없었다. 결론: 자간전증이 있는 미산부에서 분만당시에 측정한 혈중 호모시스테인은 증가하며, 자간전증을 예측할 수 있는 위험인자로 유용될 수 있을 것으로 사료된다. 호모시스테인이 자간전증 발병에 어떤 역할을 하는지, 그리고 자간전증을 어떻게 예방할 수 있는지에 대한 더 많은 연구가 필요할 것으로 사료된다. Objective: This study was designed to determine whether homocyst(e)ine is elevated in nulliparous pregnant women with preeclampsia, and to evaluate a clinical usefulness of elevated plasma homocyst(e)ine with preeclampsia as a risk factor. Methods: Of 40 nulliparous pregnant women studied from October, 1997 to March, 1998, 20 had preeclampsia (severe: 9, mild: 11; 13 early onset preeclampsia of 20) and 20 were normal pregnant controls. We measured plasma homocyst(e)ine levels by high performance liquid chromatography , and folic acid and vitamin B12 concentrations by radioimmunoassay at the time of their delivery. Results: Mean (standard deviation) plasma homocyst(e)ine levels in the two groups, 20 nulliparous women with preeclampsia and 13 nulliparous women with early onset preeclampsia, were significantly higher than in the 20 nulliparous women without preeclampsia, respectively (12.61±3.06 versus 6.63±1.72 μmol/L, P<0.05; 12.71±3.41 versus 6.63±1.72 μmol/L, P<0.05). Folic acid and vitamin B12 concentrations were not significantly different between two groups, respectively (folic acid, 6.86±2.96 versus 8.17±3.26 nmol/L; vitamin B12, 237.8±73.1 versus 277.4±68.9 pmol/L). Mean (standard deviation) plasma homocyst(e)ine levels were not significantly different between severe and mild preeclampsia(13.79±3.23 versus 11.65±2.68 μmol/L). Conclusion: Homocyst(e)ine levels are elevated in nulliparous pregnant women with preeclamsia at the time of their delivery and might be useful to predict the preeclampsia as a risk factor. Further studies are required to determine what role homocyst(e)ine may play in the etiology of preeclampsia, and to investigate how to prevent preeclampsia.

흉부형 심장이소증의 산전진단 1 례

김성도,김명숙,한종설,송혜섭,이교원,윤성준,신봉식,금주섭,오태윤 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.10

Ectopia cordis is defined as a congenital malposition of the heart partially or completely outside the thorax and often associated with sternal and congenital heart defects:surgical repair is generally unsuccessful because of the magnitude of the deformity and the associat-ed intracardiac anormalies. Four types of ectopia cordis are described : cervical, thoracic, abdominal and thoracoa- bdominal. Cervical and thoracic type are often fatal within days, because the heart is expo- sed and malformed. Abdominal type carries a better prognosis because cardiac abnormalities are less often found. The prognosis of thoraco-abdominal type mainly depends on the pre- sence of intracardiac abnormalities. We have experienced a case of thoracic ectopia cordis at 25 weeks` gestation by ultra- sonography, so present the case and the review with literature briefly.

만삭분만의 예측지표로서의 태아 Fibronectin과 유도분만시 Misoprostol의 효용성 연구

김성도,한종설,송혜섭,최재호,이교원,김범영,신봉식,고염규 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.9

결론적으로 태아 fibronectin 정성 검사와 Bishop 점수를 병행하여 유도분만의 시기를 결정하는데 사용한다면 제왕절개 수술률을 감소시키면서 유도분만을 성공적으로 수행할 수 있을 것으로 사료된다. Objective: To evaluate the efficacy of misoprostol induced induction of term labor according to the presence fo fetal fibronectin in cervicovaginal secretion. Methods: 90 women scheduled for induction of labor were examined for Bishop score and were undergone for intravaginal application of 50 ㎍ of misoprostol at 6 hours interval. Misoprostols were administered continuously unless any of regular labor, spontaneous rupture of membrane or fetal distress occurred. In our study, 49 cases showed fibronectin positive cervicovaginal secretion, 41 cases showed fibronectin negative cervicovaginal secretion, 15 cases undergone for cesarean section. Results: 1. No significant difference were observed in Bishop`s score between the two groups. (4.72±0.98 versus 4.47±1.05). 2. Mean numbers of misoprostol administration were 1.33±0.57 and 2.03±1.03 in positive group and negative group respectively. Mean times required from labor induction to vaginal delivery were 470±388 min and 861±513 min respectively. Vaginal delivery in 12 hours were 79% and 50% in positive group and negative group respectively. 3. Dividing the cases according to the high and low Bishop score with cutoff level Bishop score of 5, mean numbers of misoprostol administration were 1.11±0.32 and 2.86±0.86 in high score group and low score group respectively. Mean times required from labor induction to vaginal delivery were 380±227 min and 1266±443 min in high score group and low score group respectively. Vaginal delivery in 12 hours were 89.9% and 14.3% in high score group and low score group respectively. Conclusion: Above study results suggest that fetal fibronectin qualitative immunoassay along with the evaluation of Bishop score might play important role in determining the appropriate timing of labor induction.