Induction of labour in pregnancies with fetal demise: a randomised control trial

Background: The present study aims at comparing efficacy and safety of two different regimens of induction of labour (IOL) in pregnancies with fetal demise.Settings and Design: A randomised controlled trial was conducted on 100 eligible pregnant women diagnosed with intrauterine fetal demise who were admitted in the labour ward of a tertiary care hospital.Methods: All participants were randomly divided into two groups in group A and group B. In Group A, IOL was done with transcervical foley’s catheter and vaginal misoprostol while in group B, mifepristone with vaginal misoprostol were used for IOL. During intrapartum period the mode of delivery, induction-delivery interval, total dose of induction agent used and amount of total blood loss were noted. Any side effect if present was also noted.Results: Comparing both the groups, Induction delivery interval was less in group A as compared to group B.Conclusions: Use of mifepristone with misoprostol as well as Foley’s with misoprostol were found to be equally safe and effective methods.

Randomized and controlled trial to determine safety and efficacy of Foley’s catheter and PGE2 gel for induction of labor

Background: The goal of obstetrics is a pregnancy that results in a healthy infant and a healthy mother. During medical or obstetrics complications of pregnancy, cervical ripening and induction of labor are often required. Different methods are available for that. Aims and Objectives: Randomized and control trial has been conducted to determine safety and efficacy of Foley’s catheter and prostaglandin E2 (PGE2) gel for induction of labor. Materials and Methods: Randomized and controlled trial has been conducted on 200 study participant who fullfield inclusion criteria in Department of Obstetrics and Gynaecology, GMERS Medical College, Sola during the period of July 2017–July 2019. Statistical analysis was done by descriptive statistics and qualitative method. Results: Both groups cerviprim and Foley’s catheter are comparable for cervical ripening for induction of labor in terms of safety and efficacy as there was no statistically significant observation for obstetric and perinatal outcome. Conclusion: Foley’s catheter is equally dependable method for cervical ripening for induction of labor as cerviprim gel as it is cost effective and easily available.

Comparison of the efficacy, safety, acceptability and fetomaternal outcomes of combination of mifepristone and foley’s catheter with foley’s catheter alone in induction of labour in term pregnancies with previous lower segment caesarean section

Background: Objective of the study was to compare the efficacy, safety, acceptability, fetomaternal outcomes of combination of mifepristone and Foley’s catheter with Foley’s catheter alone in induction of labor in term pregnancies with previous Lower segment caesarean section (LSCS).Methods: This was a prospective study of 36 women induced with mifepristone and foley’s catheter and 36 women induced with foley’s catheter alone at 37 weeks to 41+6 weeks with previous LSCS.Results: Mean bishop score on admission in combined group (2.44) was comparable with that of foley’s alone group (2.91, p=0.888). Mean Bishop score (BS) after foley’s expulsion in group A and group B was 7.46 and 6.33 respectively, which was statistically significant (p<0.001). In group A 69.5% of women delivered vaginally compared to 52.2% in group B which was comparable (p=0.230). Mean induction to delivery interval was significantly short in combination group (15.5±1.3 hours versus 20.8±1.07 hours, p=0.003). 50% women in group A required oxytocin for induction/ augmentation of labour as compared to 77.8% in group B (p=0.02). Failed induction was statistically higher in group B (p<0.05). No difference was found with regards scar dehiscence, scar rupture, Postpartum hemorrhage (PPH), wound infection, puerperal pyrexia, Meconium stained liquor (MSL), fetal distress, mean birth weight, 1 and 5 minutes Appearance, pulse, grimace, activity, and respiration (APGAR) score, neonatal outcome, hospital stay.Conclusions: Priming with mifepristone before insertion of foley’s catheter results in significant change in BS signifying that combination promotes early cervical ripening as compared to foley’s catheter alone. Mifepristone plays significant role in cervical ripening, reduces induction to delivery interval, oxytocin requirement and failed induction.

A comparative study of vaginal misoprostol, dinoprostone gel, foley catheter, extra amniotic saline infusion along with vaginal misoprostol for induction of labor at term

Background: Objective of this study was to study the effect of vaginal misoprostol, dinoprostone gel, foley catheter, extra amniotic saline infusion along with vaginal misoprostol for induction of labor at term on maternal and fetal outcome.Methods: A one-year prospective observational study was conducted in the department of obstetrics and gynecology, SDM College of Medical Science and Hospital, Dharwad. Totally 100 postdated primigravida women with singleton gestation, vertex presentation and intact membrane who were induced with any four methods of induction 1) Tab. misoprostol 25 µg vaginally, 2) Intracervical dinoprostone gel, 3) Foley catheter and 4) Extra amniotic saline infusion along with tab. misoprostol 25 µg vaginally with 25 patients selected in each group, by random allocation technique and included in the study. Outcome measures analysed were the demographic profile, bishop score, induction to delivery interval, mode of delivery, maternal and fetal complications. Statistical analysis was done using SPSS 17 software.Results: Mean induction delivery interval was significant between PGE1 versus foley group (p=0.0034). In this study, 60% patients in dinoprostone group had Vaginal delivery and 72% in the EASI + misoprostol group underwent cesarean section (p=0.0372). NICU admission was maximum with EASI + vaginal misoprostol group and minimum with vaginal misoprostol alone.Conclusions: The groups were comparable with respect to maternal age, bishop score and fetal weight. The vaginal misoprostol group had shortest induction delivery interval. The maximum number of patients in dinoprostone gel group underwent vaginal delivery with a highest cesarean section and NICU admission with the EASI + misoprostol group.

A comparative study of intracervical foley’s catheter with oxytocin and vaginal misoprostol for induction of labour

Background: Induction of labour implies stimulation of uterine contraction before spontaneous onset of labour with or without ruptured membranes. Aim of this study was to compare the efficacy and safety of intracervical Foley’s catheter with oxytocin and vaginal misoprostol for labour induction at term.Methods: A total 100 term pregnant women were chosen with bishop score <6 and divided into two groups: Foley’s catheter with oxytocin (Group A) and vaginal misoprostol (Group B). In Group A, a 16 F Foley’s catheter introduced beyond internal os and traction applied every 4 hourly to check for expulsion with simultaneous oxytocin infusion (2 mU/min up to 32 mU/min). In Group B, 25 mcg misoprostol administered every 4 hourly (maximum 6 doses or 150 mcg). Data analysed using SPSS software 20.0. A p value <0.05 was considered statistically significant.Results: No statistical difference found between demographic variables between two groups. Both primigravida and multigravida had poor pre-induction bishop score in both groups. Foley’s catheter (80%) and misoprostol group (96%) had successful induction and was statistically significant (p<0.05). Foley’s catheter took more time from induction-delivery both in primigravida and post-dated pregnant women. The rate of cesarean in Foley’s catheter group was high (62.5%) including 33% cases with failed induction. Foley’s catheter had less maternal and neonatal complications, less NICU admission as compared to misoprostol (p>0.05).Conclusions: Misoprostol was found better for successful induction, decreases induction-to-delivery interval and increases vaginal delivery as compared to Foley’s catheter but it needs constant supervision in view of hyperstimulation and tachysystole.

A comparative study of transcervical foley’s catheter with intracervical PGE2 gel for pre-induction cervical ripening

Background: To compare the efficacy of transcervical foley’s catheter with intracervical PGE2 gel for pre -induction cervical ripening.Methods: It was a prospective interventional study conducted between April 2012 to April 2013 in the department of obstetrics and gynecology at L. L. R. M. medical college and S. V. B. P. hospital Meerut. A total of 80 pregnant women of ≥28 weeks of gestation with bishop score less than or equal to 4 and with various indications for induction of labour were randomly allocated to receive intracervical PGE2 gel (Group A) or transcervical foley’s catheter (Group B). Bishop score was repeated after 6 hours by the same person and the results were compared.Results: The groups were comparable with respect to maternal age, gestational age, indications of induction of labour and initial bishop’s score. The intragroup results were calculated by Wilcoxon signed rank test and intergroup results were calculated by Mann Whitney U-test. The change in bishop score in PGE2 group was 3 and in foley’s group was 3.25 after 6 hours of induction (interquartile range of median) which is significant. The mean change in bishops score was 2.65 in PGE2 group and 3.1 in foley’s group after 6 hours of induction and was significant, however the bishop’s score was comparable in both the groups and statistically insignificant.Conclusions: Both foley’s catheter and PGE2 gel are equally effective in pre-induction cervical ripening of cervix.

Comparative evaluation of intravaginal slow release Dinoprostone insert, transcervical foley’s catheter, intracervical Dinoprostone gel for induction of labor in patients with poor Bishop’s score: a randomized control study

Background: Induction of labor is indicated when the continuation of pregnancy poses risk to the mother or fetus. A variety of mechanical and pharmacologic methods are available but the best method of labor induction still remains unknown, study aimed at comparing the efficacy and safety among the two agents: transcervical Foley’s balloon catheter (FBC) and intravaginal slow release Dinoprostone E2 insert (DVI) with dinoprostone gel as control.Methods: A total of 174 patients were randomized into three groups of 58 each (Group A: dinoprostone 10 mg slow release intravaginal insert, Group B: transcervical Foley’s 16 French catheters, and Group C as control: 0.5 mg intracervical Dinoprostone gel. The safety and efficacy was compared among the groups. A p value of < 0.05 was considered statistically significant.Results: The mean insertion to active labor time (in hours) was significantly lower in Group A as compared to Group B (5.88±3.06 versus 13.56±2.8, p < 0.0001). Meantime of insertion to delivery (in hours) was significantly lower in Group A as compared to Group B (10.91±5.24 versus 21.17±2.99, p < 0.0001). The requirement of oxytocin for induction and augmentation in Group A was significantly lower as compared to Group B. Majority of the patients had normal vaginal delivery (NVD) in all the three groups. Regarding safety profile we found that slow-release DVI had more incidence of uterine tachysystole, but none of the cases had any fetal heart rate abnormality. Maternal fever was more in the FBC group, however, neonatal outcomes were comparable in both groups.Conclusions: The study concludes that slow release DVI is better in terms of efficacy as compared to transcervical FBC for induction of labor as assessed by improvement in Bishop score, insertion to active labor time and insertion to delivery time and comparable in terms of safety profile.

A comparative study of intra-cervical foley’s catheter and PGE2 gel for induction of labour at term

Background: In cervical ripening, before induction of labour, is needed to increase the success of labour induction, to reduce complications and to diminish the rate of caesarean section and duration of labour. Pharmacological preparations are in widespread use for cervical ripening but are not free from side-effects and complications. Mechanical methods, i.e. the use of Foley’s catheter balloon, though effective have not gained much popularity because of the fear of infection. Therefore, the study has been conducted to prove the efficacy and safety of extra amniotic Foley catheter balloon and to compare it with intra-cervical prostaglandin E2 (PGE2) gel. The objective of the study was to the success of induction of labor depends on the cervical status at the time of induction. For effective cervical ripening both Foley's catheter and PGE2 gel are used. The aim of this study was to compare the efficacy of intra cervical Foley's catheter and intra cervical PGE2 gel in cervical ripening for the successful induction of labor.Methods: A randomized, comparative study was conducted in the department of obstetrics and gynaecology, Civil hospital, B.J. Medical College Ahmedabad, during a period of 8 month from September 2018 to April 2019. 100 patients at term with a Bishop's score ≤5 with various indications for induction were randomly allocated to group F (intra-cervical Foley’s catheter) and group P (PGE2 gel) with 50 women included in each group.Results: The groups were comparable with respect to maternal age, gestation age, indication of induction and initial Bishop's score. Both the groups showed significant change in the Bishop's score, 5.10±1.55 and 5.14±1.60 for Foley's catheter and PGE2 gel, respectively, p <0.001. However there was no significant difference between the two groups. There was no significant difference in the side effects and caesarean section rate in both groups. The induction to delivery interval was 16.01±5.50 hours in group F and 16.85 ± 3.81 hours in group P (p=0.073). Apgar scores, birth weights and NICU admissions showed no significant difference between the two groups.Conclusions: The study shows that both Foley's catheter and PGE2 gel are equally effective in pre induction cervical ripening.

Induction of labor in women with unfavourable cervix: comparison of efficacy of intracervical Foley catheter with PGE2 gel

Background: The aim of our study was to compare the efficacy, safety and patient’s satisfaction of intracervical Foley catheter with intracervical dinoprostone gel (PGE2 gel) for cervical ripening for successful induction of labor.Methods: Prospective study was conducted in Department of Obstetrics and Gynaecology, M P Shah Medical College, Jamnagar, Gujarat. 317 women with term pregnancy with bishop score of less than 4 with various indications for induction were included. Intracervical foley catheter was kept in 162 women for cervical ripening (group A) while intracervical PGE2 gel was kept in rest 155 women (group B).  The change in the bishop score, progress of labor, adverse effects and outcome of labor along with the patient’s satisfaction were assessed.Results: With regard to the obstetrical parameters, the two groups were comparable with respect to maternal age, gestational age, parity, indication for induction and initial bishop score. At 12 hours, both the groups showed significant improvement in bishop score, 5.2±1.81 and 4.8±1.76 in Foley catheter and PGE2 gel respectively. Mean induction to delivery interval was 18.8±5.5 in group A and 17.9±5.3 in group B, which was statistically insignificant.  No significant differences in side effects, mode of delivery and APGAR score were noted in both the groups. However, the incidence of hyperstimulation and tachysystole was higher in PGE2 gel group.Conclusions: This study shows that both Foley catheter and dinoprostone gel appear to be equally effective agents for cervical ripening. Infect foley catheter is cheap, causes less fetal distress and is safer than PGE2 gel.

Efficacy of vaginal Misoprostol versus transcervical Foley’s catheter and vaginal Misoprostol in induction of labor

Background: The objective is to compare the efficacy of vaginal Misoprostol versus transcervical Foley’s catheter and vaginal Misoprostol.Methods: A prospective study analyzing the comparative efficacy of intravaginal instillation of Misoprostol in two groups (tablet Misoprostol 50mg alone and combination of intracervical Foley’s catheter and tablet Misoprostol 50mg) carried out in the labour room on 300 subjects (150 subjects in each group), from May 2013 to November 2015.Results: The common gestational age at the time of induction was 36-40 weeks and the most common indication was premature rupture of membrane. In both the groups, most of the cases delivered within 12 hours. present results show that statistically significant number of cases delivered vaginally within 12 hours with the group using Misoprostol plus Foley’s catheter as compared to the group using Misoprostol alone. Cesarean section rate was 12.67% in Misoprostol group and 10.67% in Misoprostol plus Foley’s catheter group. Incidence of failure of induction was similar in both the groups. The incidence of babies with Apgar score less than 8/10 at 5 minutes and incidence of early neonatal death were similar in both the groups.Conclusions: Addition of intracervical Foley’s catheter to vaginal Misoprostol for induction of labor in subjects with unfavorable cervices reduces the Induction-Delivery interval without added side effects or complications to the mother and fetus.

Sonda Foley: una alternativa efectiva para la inducción del trabajo de parto / Foley catheter: An effective alternative for induction of labor

Resumen OBJETIVO: Determinar la efectividad de la inducción del trabajo de parto con sonda Foley en pacientes con embarazo a término, con cesárea previa. MATERIALES Y MÉTODOS: ensayo clínico, no controlado, efectuado en pacientes con embarazo de término que acudieron al servicio de Tococirugía de un hospital de segundo nivel de atención de Sonora, México, entre enero y agosto de 2017. Para el procedimiento de inducción se colocó una sonda Foley intracervical, insuflándose el globo con 30-40 cc de solución y ejerciendo tracción constante y lenta. Se estimó el tiempo de inicio de la inducción y se mantuvo en vigilancia constante a la madre y al feto. Se revaloró la escala de Bishop a las 6 h, considerándose efectiva la inducción con la obtención del puntaje ≥ 6. También se valoró la vía de finalización del embarazo. RESULTADOS: Se estudiaron 36 pacientes; en 34 de 36 pacientes la sonda Foley fue efectiva. En cuanto a paridad, 13 de 26 eran primigestas. La inducción con sonda Foley fue exitosa en 34 de 36 pacientes, con vía de finalización del embarazo mediante parto en 24 de 36 y cesárea en 12 de 36 mujeres. Del total de participantes, 10 de 36 tenían cesárea previa, culminando 6 de 10 por parto y 4 de 10 por cesárea. CONCLUSIONES: La inducción de trabajo de parto con sonda Foley es efectiva y representa una buena alternativa en pacientes con antecedente de cesárea previa.

Abstract OBJECTIVE: To determine the effectiveness of induction of labor with Foley catheter in patients with full term pregnancy. MATERIAL AND METHODS: uncontrolled clinical trial in patients carried out in patients with term pregnancy who attended the Toco-surgery service of a second-level care hospital in Sonora, Mexico, between January and August 2017. To procedure: insufflating the balloon with 30-40cc of solution and exerting constant and gentle traction. The induction start time was taken and constant monitoring of the binomial was maintained. Bishop's scale was re-evaluated at 6 o'clock, with induction considered effective, obtaining a score on the modified Bishop's scale ≥6. The route of termination of pregnancy was also valued. RESULTS: 36 patients were studied; The efficacy of induction with Foley catheter was reported in 34 of 36 patients (94%). For parity, 13/26 women were primigravite. Induction with Foley catheter was successful in 34 of 36 patients, with a route of termination of pregnancy through delivery in 24/36 and cesarean section in 12/36 women. Of the total number of participants, 10 of 36 had a previous caesarean section, culminating 6/10 per delivery and 4/10 by caesarean section. CONCLUSIONS: The induction of labor with Foley catheter is effective and is a good alternative when there is a history of a previous caesarean section.

Eficacia y seguridad de la sonda Foley transcervical y oxitocina vs oxitocina sola en la inducción del trabajo de parto en pacientes con cesárea previa / Efficacy and safety of the use of transcervical Foley catheter plus oxytocin vs oxytocin only in the induction of labor in patients with previous caesarean section

Resumen OBJETIVO: Evaluar si la combinación de la sonda Foley transcervical con oxitocina intravenosa, como método para inducción del parto en pacientes con cesárea previa, es más efectiva que la oxitocina sola para alcanzar una fase activa del trabajo de parto y, por consiguiente, incrementar la frecuencia de partos. MATERIALES Y MÉTODOS: Estudio de casos y controles efectuado en el Centro Hospitalario Nuevo Sanatorio Durango del 1 de marzo de 2017 al 31 de marzo de 2018. Criterios de inclusión: edad gestacional mayor o igual a 37 semanas, cesárea previa con incisión transversal baja (Kerr), embarazo único, feto en presentación cefálica. Se crearon dos grupos: A: inducción del parto con oxitocina intravenosa y B: inducción con sonda Foley transcervical y oxitocina. Las variables categóricas se describieron con frecuencias y porcentajes, y las numéricas con media (±), desviación estándar o mediana. Se utilizó la prueba de Kolmogorov-Smirnov y t de Student y se consideró estadísticamente significativo un valor de p < 0.05. RESULTADOS: Se estudiaron 50 pacientes; en el grupo A 16/25 lograron una fase activa del trabajo de parto y 14/25 tuvieron parto vaginal. En el grupo B 25/25 alcanzaron la fase activa y 17/25 tuvieron parto vaginal (p > 0.05; IC95%: 0.16-0.4). El tiempo del trabajo de parto fue: grupo A con una media de 17.11 horas y en el grupo B de 12.44 (p < 0.05; IC95%: 2.4-6.2 y 2.4-6.3, respectivamente). CONCLUSIONES: Por lo menos en la muestra estudiada la combinación de sonda Foley transcervical con oxitocina demostró ser sumamente eficaz y segura para la inducción del trabajo de parto en pacientes con cesárea previa; se consiguió disminuir significativamente el tiempo de trabajo de parto y aumentar la frecuencia de pacientes que logran llegar a una fase activa del trabajo de parto.

Abstract OBJECTIVE: To evaluate whether the combination of transcervical Foley catheter with intravenous oxytocin as a method for induction of labor in patients with previous caesarean section is more effective than using only intravenous oxytocin in achieving an active phase of labor and therefore increasing the frequency of vaginal delivery. MATERIALS AND METHODS: Case-control study performed at the Nuevo Sanatorio Durango Hospital Center from March 1, 2017 to March 31, 2018. Case-control study carried out at the New Sanatorio Durango Hospital Center from March 1, 2017 to March 31, 2018. Inclusion criteria: gestational age greater than or equal to 37 weeks, previous caesarean section with low transverse incision (Kerr), pregnancy unique, fetus in cephalic presentation. Two groups were created: group A, induction of labor with intravenous oxytocin and group B induction with transcervical foley plus oxytocin. The categorical variables are described with percentages and percentages, and the numerical variables with means ± standard deviation or median. The Kolmogorov-Smirnov test and Student's t test were used; A value of p <0.05 was considered statistically significant. RESULTS: Patients were studied, in group A of 25 patients, 16/25 achieved an active phase of labor and 14/25 had vaginal resolution; group B of 25 patients, 25/25 reached the active phase and 17/25 had vaginal resolution, we obtained a value of p > 0.05 (95%CI: 0.16-0.4). The time in labor hours: group A with an average of 17.11 hours and in group B of 12.44, p value < 0.05 (95%CI: 2.4-6.2 and 2.4-6.3). CONCLUSIONS: The combination of transcervical Foley catheter with oxytocin proved to be highly effective and safe for the induction of labor in patients with a previous caesarean section, significantly reducing labor time and increasing the frequency of patients who achieve an active dose of labor.

Uso del balón cervical vs. prostaglandinas endocervicales para la inducción del parto en embarazo a término: revisión breve de literatura / Use of the cervical balloon vs. endocervical prostaglandins for the induction of labor in term pregnancy: literature brief review / Usando a bola cervical vs prostaglandinas endocervicais para indução do parto em gestação a termo: breve revisão da literatura

ResumenLas prácticas del cuidado del embarazo y el parto varían ampliamente entre los países, las instituciones y los diferentes equipos encargados del cuidado obstétrico: en este contexto con prácticas tan diversas, la práctica clínica basada en la evidencia permite que el accionar de los profesionales encargados del cuidado obstétrico se fundamente en la mejor evidencia disponible. El objetivo del presente estudio es analizar la mejor evidencia científica disponible sobre los efectos adversos del uso del balón cervical durante y posterior a la labor de parto, en comparación con el uso de prostaglandinas endocervicales para la inducción del parto en mujeres con embarazo a término. La secuencia de etapas para la recolección de la información se inició con la aplicación del mapa de búsqueda en las bases de datos MEDLINE, PUBMED y COCHRANE LIBRARY, a partir de los siguientes criterios de filtro de información: artículos publicados entre los años 2010 al 2015, mujeres gestantes de cualquier edad, únicamente se incluyó estudios como ensayos aleatorizados controlados, revisiones sistemáticas, meta-análisis o guías de práctica clínica y de preferencia artículos científicos en idioma inglés o portugués. Esta búsqueda y análisis de la evidencia encontrada se realizó durante los meses de abril y mayo del año 2015 por dos revisores. Los resultados obtenidos para el análisis crítico fueron revisados minuciosamente a través de la plataforma informática FCL 2.0 con las plantillas de ensayo clínico y revisión sistemática incluidas en los anexos. Se concluye que la utilización del balón endocervical comparado con el uso de prostaglandinas endocervicales presenta menos efectos adversos de manera específica durante la labor del parto. En relación con los efectos adversos posteriores, no se encuentra mayor diferencia entre uno u otro método.

AbstractPregnancy and childbirth care practices vary widely across countries, institutions, and different obstetrical care teams: in this context with such diverse practices, evidence-based clinical practice allows the Obstetric care is based on the best available evidence. The objective of the present study is to analyze the best available scientific evidence on the adverse effects of cervical balloon use during and after labor, compared to the use of endocervical prostaglandins for induction of labor in women with term pregnancy. The sequence of steps for the collection of information was initiated with the application of the search map in the databases MEDLINE, PUBMED and COCHRANE LIBRARY, based on the following information filter criteria: articles published between the years 2010 to 2015, Pregnant women of any age, only included studies such as randomized controlled trials, systematic reviews, meta-analyzes or guidelines of clinical practice and preferably scientific papers in English or Portuguese. This search and analysis of the evidence found was carried out during the months of April and May of the year 2015 by two reviewers. The results obtained for the critical analysis were carefully reviewed through the FCL 2.0 computer platform with the clinical trial templates and systematic review included in the annexes. It is concluded that the use of the endocervical balloon compared to the use of endocervical prostaglandins presents less adverse effects specifically during labor. In relation to the subsequent adverse effects, no greater difference is found between one or the other method.

ResumoPráticas de cuidados a gravidez eo parto variam amplamente entre os países, instituições e diferentes equipas de cuidados obstétricos; neste contexto como práticas diversas, a prática clínica baseada em evidências permite que as ações dos profissionais responsáveis pela assistência obstétrica é baseada na melhor evidência disponível. O objetivo deste estudo é analisar a melhor evidência científica disponível sobre os efeitos adversos durante e após o parto com o uso de bola cervical em comparação com o uso de prostaglandina endocervical para indução do parto em mulheres com gravidez a termo. A sequência dos passos para a recolha de dados começa com a busca do mapa aplicação em Medline, PubMed e os dados Cochrane Library, onde os seguintes critérios de filtro de informação artigos introduzidos foram seleccionados publicação período entre 2010 e 2015, a população foi delimitada a mulheres grávidas de qualquer idade, digite apenas ensaios estudos clínicos randomizados, revisões sistemáticas, meta-análises ou diretrizes de prática clínica e artigos científicos de preferência em Inglês ou Português foram incluídos. Esta pesquisa e análise da evidência encontrada foi realizado durante os meses de Abril e Maio de 2015, dois colaboradores. Os resultados obtidos para a análise crítica foram cuidadosamente controlados através da plataforma FCL computador 2,0 modelos ensaio clínico e revisão sistemática estão incluídos nos anexos. Concluiu-se que o uso de bola endocervical em comparação com a utilização de prostaglandinas endocervicais tem menos efeitos adversos especificamente durante o trabalho de parto. Em ligação com os efeitos adversos subsequentes não é maior diferença entre qualquer um dos métodos.

Sonda de Foley transcervical-oxitocina u oxitocina sola para la inducción del parto en embarazos a término / Transcervical Foley catheter­endovenous oxytocin or oxytocin alone for induction of labor in term pregnancres

Objetivo. Comparar la efectividad de la sonda de Foley transcervical más oxitocina con oxitocina endovenosa sola, en la inducción del parto en embarazos a término. Diseño. Estudio de casos y controles. Institución. Hospital Central "Dr. Urquinaona", Maracaibo, Venezuela. Participantes. Embarazadas a término que asistieron para maduración cervical e inducción del parto asignadas al azar con sonda de Foley transcervical - oxitocina endovenosa (grupo A) u oxitocina endovenosa (grupo B). Principales medidas de resultado. Características generales, intervalo inicio de la inducción y el parto, tasa de parto vaginal, complicaciones maternas, variables perinatales y efectos adversos. Resultados. No se encontraron diferencias estadísticamente significativas entre los grupos con relación a las características generales (p = ns). Las pacientes del grupo A presentaron un intervalo significativamente menor desde el inicio de la inducción hasta el parto comparado con las pacientes del grupo B (p < 0,05). No se hallaron diferencias significativas con relación a la tasa de partos vaginales entre los grupos (p = ns). No hubieron diferencias en los valores de Ápgar al minuto y a los 5 minutos entre los recién nacidos de ambos grupos (p = ns). El efecto adverso más común en ambos grupos fue náuseas, pero no se hallaron diferencias estadísticamente significativas entre los grupos en la frecuencia de efectos adversos (p = ns). Conclusión. El uso sonda de Foley transcervical más oxitocina disminuye el intervalo entre el inicio de la inducción y el parto comparado con la oxitocina sola, con una incidencia similar de efectos adversos maternos y perinatales.

Objective: To compare the effectiveness of transcervical Foley catheter - oxytocin with oxytocin alone for labor induction in term pregnancies. Design: Case-control study. Setting: Hospital Central "Dr. Urquinaona", Maracaibo, Venezuela. Participants: Pregnant women undergoing cervical ripening and labor induction were randomly assigned to be treated with transcervical Foley catheter - oxytocin (group A) or oxytocin alone (group B). Main outcome measures: General characteristics, interval between beginning of induction and delivery, vaginal birth rate, maternal complications, perinatal variables, and adverse effects were evaluated. Results: There were no significant differences between groups in general characteristics (p = ns). Patients of group A showed a shorter interval between the beginning of induction and delivery compared with patients in group B (p < 0.05). There was no significant difference in vaginal birth rate between groups (p = ns). Newborns of both groups had similar mean values of Apgar scores at 1 minute and 5 minutes (p = ns). The most common adverse effect in both groups was nausea, but there were no significant differences between groups in frequency of adverse effects (p = ns). Conclusions: Use of transcervical Foley catheter - oxytocin shortened the interval between beginning of induction and delivery compared with oxytocin alone, with similar incidence of maternal and perinatal adverse effects.

Humble Foley's catheter to the rescue in a case of T-tube insertion: a case report / 대한마취과학회지

The Montgomery T-tube poses a challenge to anesthesiologists because of loss of anesthetic gases through the open proximal end of the vertical limb and lack of standard anesthesia circuit connectors. Here, we present a case of a 25-year-old woman with a reported history of accidental strangulation 18 months previously. The patient had a metallic tracheostomy tube in situ due to the development of tracheal stenosis. Computed tomography showed significant narrowing in a 7–8-mm segment, 2 cm proximal to the tracheostomy tube in situ. She was scheduled for tracheal reconstruction surgery and T-tube insertion due to persistent subglottic stenosis. In this case, the Foley's catheter, which was inserted into the glottis orally, not only aided easy insertion of the T-tube into the trachea through the tracheal stoma, but also enabled us to stop the loss of anesthetic gases through the proximal vertical limb of the T-tube.

Advantages of foley catheter for nephrostomy tube after minimally invasive percutaneous nephrolithotomy / 中南大学学报(医学版)

Objective:To assess the advantages and nursing experience of foley catheter for nephrostomy tube after minimally invasive percutaneous nephrolithotomy (mPCNL).Methods:From October 2015 to April 2016,the clinical data of 137 patients,who were diagnosed with upper urinary tract calculi and need to perform mPCNL,were collected and randomized into 2 groups:a foley catheter group (research group,n=69) and a normal nephrostomy tube group (control group,n=68).The patients in research group used foley catheter for nephrostomy tube,while those in the control group used normal nephrostomy tube.Bleeding volume,the days of bleeding,pipes shedding and pain degree were compared,and the experience of the nursing process was summarized.Results:The bleeding volume,the days of bleeding in the research group were significantly lower than those in the control group (both P＜0.01).The pipes shedding rate in the research group were lower than that in the control group (P＜0.05).There was no significant difference in postoperative pain scores between the 2 groups (P＞0.05).There was no other complications and discomfortable symptoms in the experimental group.Conclusion:The use of foley catheter for nephrostomy tube after mPCNL is safe,and it can decrease the bleeding volume and pipes shedding rate.It doesn't increase the patient's postoperative pain and can reduce the difficulty and risk for postoperative nursing.

Preventing Effect of Different Dosages of Progynova in Intrauterine Adhesions After TCRS Under Laparoscope / 医药导报

Objective To explore the effect of different dosages of progynova in preventing intrauterine adhesions after transcervical resection of septum ( TCRS) under laparoscope. Methods Clinical data of 213 TCRS patients under laparoscope were retrospectively analyzed, and these cases were divided into four groups according to the dosages of progynova. Except for group A (n=26), group B, C, D were given 4,6,8 mg.d-1 of progynova.Endometrial thickness, menstrual blood volume, incidence rates of residual septal and intrauterine adhesions, rate of adverse effect, pregnancy rate after operation and rate of spontaneous abortion were compared among the four groups. Results The incidence rate of residual septal in group A, B, C, D was 11.5%, 6.9%, 6.0% and 6.3%, respectively.Incidence rate of intrauterine adhesions after operation was 46.2%, 12.5%, 9.0% and 4.2%, respectively.The pregnancy rate in group A, B, C and D was 30.8%, 59.7%, 58.2% and 60.4%, respectively. There were significant differences between group A and the other groups(all P<0.05).The high dose of progynova(8 mg.d-1) significantly increased endometrial thickness ( P<0. 05 ) and menstrual blood volume ( P<0. 05 ) . But the incidence rates of gastrointestinal tract reaction, hepatic damage and vaginal spotting in the high dose group of progynova increased obviously( P<0.05) . Conclusion Progynova is a safe and effective drug in preventing intrauterine adhesions after TCRS. It can effectively prevent intrauterine adhesions, increase pregnancy rate and improve pregnant outcome.

Intracervical foley catheter balloon versus oxytocin infusion as pre-induction cervical ripening agent in live term pregnancies with unfavorable cervices / Philippine Journal of Obstetrics and Gynecology

OBJECTIVE: The purpose of this study was to evaluate the effectiveness and safety as well as maternal and fetal outcome of intracervical Foley catheter balloon versus oxytocin infusion as pre-induction cervical ripening agents in live term pregnancies with unfavorable cervices.METHODS: Forty-two patients who fulfilled the induction criteria were randomized to 2 groups. Group 1= intracervical balloon catheter and Group 2= oxytocin infusion. Both groups were compared as to: insertion/infusion to active phase interval, induction to delivery interval, uterine hyperstimulation, pain intensity, delivery and fetal outcome. Analysis of data collected was done using Indepedent T-test.RESULTS: Statistical analysis showed no significant difference as to insertion/infusion to active phase interval (p 0.814) and induction to delivery interval (p 0.264) between the balloon and oxytocin groups. By percentage comparison, both groups have comparable results in the mode of delivery, likelihood of cesarean section and good fetal outcome. Statistical significance was observed with regards to absence of uterine hyperstimulation (p 0.036) and absence of pain (p 0.000) in favor of the balloon group.CONCLUSION: By percentage comparison, intracervical Foley catheter balloon and oxytocin were both effective and safe in achieving cervical dilatation. The Foley catheter showed statistical significance in terms of absence of uterine hyperstimulation and pain. Foley catheter is readily available and affordable. It may be considered as a good alternative to oxytocin.

Effects Foley catheter placement to expedite the process of delivery.

Background: Finding a suitable procedure in cases requiring termination of pregnancy without having a ready cervix to induction of labor, is a considerable problem in midwifery. The aim of this study was to compare the effect of Foley catheter placement with oxytocin to expedite the process of delivery. Methods: This is an interventional study. In this study, patient information including age, gestational age, residence place, education, induction time, induction complications, cesarean delivery after induction were entered in a checklist. Collected data analyzed by descriptive and analytical statistical methods in SPSS.16. Results: In this study 100 pregnant women were enrolled in two equal size groups, case (receiving a Foley catheter and oxytocin) and control (receiving oxytocin), each with 50 patient. The mean age of cases was 24.7±3.4 years and controls were 23.9±2.3 years and the most prevalent age group in both was 20-30. In cases 14 % and in controls 12 % were with underlying disease and 14% of women in case group and 24% of women in control group had narrowing of vaginal canal. The most common reason for starting induction in cases was lack of progress in labor and in controls dilation of delivery. The mean gestational age in cases was 39.9±1.9 and in control 39.2±1.8 weeks. In relation to dilatation progress, results showed that in cases individuals reached to full dilatation early and this difference was, in cases 14 % and in controls 22% of deliveries are ended to caesarean. 14% of deliveries in cases and 22% in controls are ended to Caesarean section. There was no significant difference between two groups in birth time Apgar score and 5 minutes after birth time. Conclusions: Results showed that, Foley catheter could significantly reduce induction time significantly and resulted to faster labor but did not reduce the rate of caesarean.

Clinical Outcome of Foley Catheter Balloon Versus Prostaglandins in Labor Induction of Late Pregnancy：A Meta Analysis / 医药导报

Objective To compare the efficacy and safety of Foley catheter (FC) and prostaglandins (PG) for cervical ripening used in labor induction of late pregnant women with unfavorable cervix. Methods Several databases including Cochrane Library,Embase,PubMed,Elsevier,Wanfang Medical Database, CNKI, VIP were searched for collecting the related literatures according to criteria for inclusion and exclusion.Meta analysis was performed by applying software Review Manager 5.2. Results Thirty randomized controlled trials were included.The FC group presented significantly lower risk of excessive uterine contraction [OR= 0.38,95%CI(0.19,0.75),P<0.05] than the PG group.There was no significant difference between the two groups in terms of Cesarean section rate, vaginal delivery rate, Bishop score improvement, duration of induction to delivery, neonatal birth weight, or in neonatal outcome. Conclusion This study shows that FC has good promoting effect of cervical maturity and maternal￣ neonatal outcomes, and rarely produces excessive uterine contraction.It is safe and equally effective as PG does.The approach is easy to operate and worth to apply in clinical use.