Método mecânico de indução do parto em gestantes de alto risco com cesariana anterior / Mechanical method of induction of labor in high-risk pregnant women with previous cesarean section

OBJETIVO: Descrever os desfechos materno-fetais com o uso da sonda de Foley para indução do trabalho de parto em gestantes de alto risco com cesariana anterior. MÉTODOS: Foi realizado um estudo de intervenção e descritivo, no período de novembro de 2013 a junho de 2014. Foram incluídas 39 gestantes a termo, com feto vivo, apresentação cefálica, peso estimado <4.000 g, cesariana prévia, com indicação de indução do trabalho de parto, escore de Bishop ≤6 e índice de líquido amniótico >5 cm. A sonda de Foley nº 16F foi introduzida, por no máximo 24 horas, sendo considerado satisfatória quando a paciente entrou em trabalho de parto nas primeiras 24 horas. RESULTADOS: O trabalho de parto foi induzido satisfatoriamente em 79,5% das gestantes. Nove mulheres evoluíram para parto vaginal (23,1%), com uma frequência de 18% de partos vaginais ocorridos dentro de 24 horas. As principais indicações da indução do parto foram as síndromes hipertensivas (75%). As médias dos intervalos entre a colocação da sonda de Foley e o início do trabalho de parto e o parto foram de 8,7±7,1 e 14,7±9,8 horas, respectivamente. A eliminação de mecônio foi observada em 2 pacientes e o escore de Apgar <7 no primeiro minuto foi observado em 5 recém-nascidos (12,8%). CONCLUSÕES: A sonda de Foley é uma alternativa para indução do trabalho de parto em gestantes com cesariana anterior, apesar da baixa taxa de parto vaginal. .

PURPOSE: To describe the maternal and fetal outcomes with the use of the Foley catheter for induction of labor in high-risk pregnant women with previous caesarean section. METHODS: An interventive and descriptive study was conducted from November 2013 to June 2014. A total of 39 pregnant women at term, with a live fetus, cephalic presentation, estimated fetal weight <4,000 g, with previous cesarean section, medical indications for induction of labor, Bishop score ≤6 and amniotic fluid index >5 cm were included. A number 16F Foley catheter was introduced for a maximum of 24 hours, and was considered to be satisfactory when the patient began labor within 24 hours. RESULTS: Labor was successfully induced in 79.5% of pregnant women. Nine women achieved vaginal delivery (23.1%), with a frequency of 18% of vaginal births occurring within 24 hours. The main indications for the induction of labor were hypertensive disorders (75%). The mean interval between the placement of the Foley catheter and the beginning of labor and delivery were 8.7±7.1 and 14.7±9.8 hours, respectively. Meconium-stained amniotic fluid was observed in two patients; and an Apgar score <7 in the first minute was detected in 5 newborns (12.8%). CONCLUSIONS: The Foley catheter is an alternative for the induction of labor in women with previous caesarean section, despite the low vaginal delivery rate. .

Efficacy of double balloon catheter in full-term women for cervical ripening and labor induction / 中国医师杂志

Objective To determine the efficacy of the double balloon catheter in ripening and dilatation of the unfavorable cervix for induction of labor .Methods A total of 332 full-term women who were underwent induction of labor with the double balloon devices were collected for retrospective analysis .Cervix was assessed before the double balloon insertion and after it was removed 12 hours later, then amniotomy alone or combined with oxytocin was performed .Cord blood gases were analyzed .Results The double balloon catheter increased Bishop score in all subgroups with a mean improvement of 2.5 ±0.7 ( P <0.05 ) .The mean insertion-deliv-ery interval was (19.07 ±4.31)h.Cesarean section was performed in 80/332 (24.1%) patients.Cord arterial pH value was 7.3 ± 0.1 .Conclusions The double balloon catheter induced significant ripening and dilatation of the unfavorable cervix .It was effective and safe.

Application of the double balloon device in labor induction for women with preeclampsia and eclampsia / 中国医师杂志

Objective To evaluate the efficacy and safety of labor induction by the double balloon device in women with preeclampsia and eclampsia.Methods Labor induction was carried out in 37 women with preeclampsia and eclampsia from July 2011 to November 2012.All the labor inductions were performed using the double balloon device.Results The cervical Bishop scores of 37 cases of patients with preeclampsia and eclampsia were significantly lower before using double balloon device [(3.38 ± 0.50) scores] compared with after using double balloon device [(6.44 ± 0.63) scores] with a statistically significant difference (t =23.54,P ＜0.01).Blood pressure had no obvious change before and after using double balloon device [SBP(158.38 ± 13.89)mmHg vs (162.48 ± 12.56)mmHg,P ＞ 0.05,and SDP(112.71± 15.53) mmHg vs (108.19 ± 8.37) mmHg,P ＞ 0.05].The rate of vaginal delivery was 89.2％ (33/37),and the total hours of labor were (5.8 ± 0.63) h.Compared with selective cesarean section,vaginal delivery after double balloon to promote cervical mature had less blood loss (t =9.19,P ＜0.01),quicker postpartum recovery,shorter hospitalization time (t =11.18,P ＜ 0.01),lower birth body mass (t =2.96,P ＜0.01) and higher scores of 1 minutes Apgar score (t =2.34,P ＜0.05).Conclusions The double balloon device appeared to be a safe and effective method to induce labor in women with preeclampsia and eclampsia.Wide scale studies and further use of the device for labor induction in women with preeclampsia and eclampsia were warranted.