Abstract:Uterine induction after a single Caesarean section with ocytocic infusion and amniotomy where the cervix is favourable does not appear to entail any significant added risk in terms of maternal or foetal morbidity. Foley catheter induction is a reasonable option if the cervix is not ripe.
“…18,19 Table 4 summarises the results of studies using Foley catheter for IOL in the presence of a caesarean scar. 14,[20][21][22][23][24] It appears that DBC achieved comparable vaginal delivery rate (60.2% vs 58.0%) and similar uterine rupture/dehiscence rate (0.85 % vs 0.65%). There was no case report of neonatal death in studies using DBC while there were two cases reported with Foley catheter.…”
Objectives: To evaluate the efficacy and safety of double balloon catheter for induction of labour in Chinese women with one previous caesarean section and unfavourable cervix at term.
Design: Retrospective cohort study.Setting: A regional hospital in Hong Kong.Patients: Women with previous caesarean delivery requiring induction of labour at term and with an unfavourable cervix from May 2013 to April 2014.
Major outcome measures:Primary outcome was to assess rate of successful vaginal delivery (spontaneous or instrument-assisted) using double balloon catheter. Secondary outcomes were double balloon catheter induction-to-delivery and removalto-delivery interval; cervical score improvement; oxytocin augmentation; maternal or fetal complications during cervical ripening, intrapartum and postpartum period; and risk factors associated with unsuccessful induction.Results: All 24 Chinese women tolerated double balloon catheter well. After double balloon catheter expulsion or removal, the cervix successfully ripened in 18 (75%) cases. The improvement in Bishop score 3 (interquartile range, 2-4) was statistically significant (P<0.001). Overall, 18 (75%) cases were delivered vaginally. The median insertion-to-delivery and removal-to-delivery intervals were 19 (interquartile range, 13.4-23.0) hours and 6.9 (interquartile range,
“…18,19 Table 4 summarises the results of studies using Foley catheter for IOL in the presence of a caesarean scar. 14,[20][21][22][23][24] It appears that DBC achieved comparable vaginal delivery rate (60.2% vs 58.0%) and similar uterine rupture/dehiscence rate (0.85 % vs 0.65%). There was no case report of neonatal death in studies using DBC while there were two cases reported with Foley catheter.…”
Objectives: To evaluate the efficacy and safety of double balloon catheter for induction of labour in Chinese women with one previous caesarean section and unfavourable cervix at term.
Design: Retrospective cohort study.Setting: A regional hospital in Hong Kong.Patients: Women with previous caesarean delivery requiring induction of labour at term and with an unfavourable cervix from May 2013 to April 2014.
Major outcome measures:Primary outcome was to assess rate of successful vaginal delivery (spontaneous or instrument-assisted) using double balloon catheter. Secondary outcomes were double balloon catheter induction-to-delivery and removalto-delivery interval; cervical score improvement; oxytocin augmentation; maternal or fetal complications during cervical ripening, intrapartum and postpartum period; and risk factors associated with unsuccessful induction.Results: All 24 Chinese women tolerated double balloon catheter well. After double balloon catheter expulsion or removal, the cervix successfully ripened in 18 (75%) cases. The improvement in Bishop score 3 (interquartile range, 2-4) was statistically significant (P<0.001). Overall, 18 (75%) cases were delivered vaginally. The median insertion-to-delivery and removal-to-delivery intervals were 19 (interquartile range, 13.4-23.0) hours and 6.9 (interquartile range,
“…A recent report by Lappen et al [38], which included 6,033 women attempting TOL after a prior Cesarean delivery, found that induction of labour in women with one prior Cesarean delivery was associated with an increased risk of failed VBAC as compared with expectant management. Another study indicated that induction after a single Cesarean delivery with oxytocin and amniotomy where the cervix is favorable is not associated with added maternal or fetal morbidity [39].…”
Maternal and neonatal morbidity: repeat Cesarean versus a trial of labour after previous Cesarean delivery Abstract Purpose: The purpose of this study was to perform a meta-analysis comparing the rates of uterine rupture, and other maternal and neonatal complications, between women who undergo a trial of labour (TOL) after a prior Cesarean delivery and those to undergo elective repeat Cesarean delivery (ERCD).Source: Medline, Cochrane, EMBASE and Google Scholar were searched until May 6, 2015 using the keywords/phrases: trial of labour, Cesarean section, elective, repeat, pregnancy and vaginal birth. Randomized controlled trials (RCTs), two-arm prospective studies, one-arm studies and retrospective studies were included. The primary outcome was uterine rupture.Principal findings: Sixteen studies were included in the meta-analysis. TOL after prior Cesarean delivery was associated with higher odds of uterine rupture as compared with ERCD (Peto odds ratio [OR] = 4.685, 95% confidence interval [CI]: 3.077 to 7.133, p < 0.001). TOL was associated with a higher rate of endometritis, a lower rate of hysterectomy, and a lower rate of respiratory problems in newborns. There were no differences between the groups with respect to neonatal intensive care unit admissions, postpartum hemorrhage, thromboembolic disease, sepsis and neonatal mortality.Conclusions: TOL may be associated with a higher risk of uterine rupture and endometritis, but lower risk of hysterectomy and neonatal respiratory problems than ERCD.
“…A taxa de parto vaginal foi menor do que a encontrada em outros estudos que utilizaram a sonda de Foley em mulheres com cesariana prévia, o qual variou entre 43,7 e 64,1% 16,17,20,21 . A alta incidência de cesáreas pode ter ocorrido em razão da nossa pequena amostra, bem como pela tendência de alguns plantonistas em realizar uma nova cesariana nas mulheres com cesariana prévia e também porque nossa principal indicação de indução do trabalho de parto foram as síndromes hipertensivas, que cursaram com seis pacientes submetidas à cesariana por picos hipertensivos.…”
Section: Discussionunclassified
“…Essa necessidade resolutiva dos plantonistas corrobora um estudo que sugere que a presença da sonda de Foley é um fator de risco isolado para uma nova cesariana 20 . Outras publicações observaram que pacientes com cesárea anterior que desencadearam o trabalho de parto espontâneo tiveram menores taxas de cesarianas, quando comparadas com mulheres que iniciaram a indução com sonda de Foley 10,20,22 . Destacamos que todas as nossas gestantes tiveram o trabalho de parto induzido com sonda de Foley, diferente dos estudos mencionados, que compararam a indução com o parto espontâneo.…”
Section: Intervalo Da Colocação Da Sonda E O Parto (Variação) (N=9) 4unclassified
“…Outro fator que pode estar envolvido na pequena taxa de parto vaginal observada neste estudo é a ausência de pelo menos um parto vaginal prévio, além da cesárea anterior, na maioria das pacientes envolvidas 4,20 . Esse dado pode ser identificado pelas características maternas do presente estudo, pois a mediana de gestações anteriores das pacientes foi de dois, e a da paridade foi de um.…”
Section: Intervalo Da Colocação Da Sonda E O Parto (Variação) (N=9) 4unclassified
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