Transcervical double-balloon catheter as an alternative and salvage method for medical termination of pregnancy in midtrimester

Abstract

There was no significant additional benefit of using a double-balloon catheter in midtrimester termination of pregnancy, although the technique was considered simple and generally well-tolerated. Placing a transcervical double-balloon catheter could be the primary method, or one of the alternative medical methods if the patient and/or obstetrician prefers no operation.

Different Methods for Termination of Mid-trimester Pregnancy With Placenta Previa 

“…The patient with comprehensive-induce methods to terminate the pregnancy in the mid-trimester had more complications of prenatal hemorrhage (30% vs 0%), postpartum hemorrhage (50.0% vs 2.4%), puerperal infection (80.0% vs 2.4%), the main reason is the patients with prenatal hemorrhage or immature cervical conditions [29] .…”

Induction of labour in mid-trimester pregnancy using double-balloon catheter placement within 12 hours versus within 12-24 hours

“…Zhang X et al [15] analyzed 1,260,684 births from the surveillance system in Zhejiang province, China, and found that the rate of birth defects during 2013, 2015, and 2017 was 245.95, 264.86, and 304.36 per 10,000 births, respectively, and there was age-related anomalies after the release of China's new two-child policy. There were many clinical problems during induced labor need to be solved, especially complete placenta previa [16], and immature cervical condition [2]. More and more women in developing countries choose to postpone pregnancy [17], and studies have found an association between elder pregnant women and a high risk of chromosomal abnormalities, miscarriages and preterm birth with gestation of less than 34 weeks.…”

“…Researchers have evaluated the effectiveness of these devices by comparing them with prostaglandins, and have reported that they are equally effective, and the incidence of tachycardia is lower than that of prostaglandins [9]. Placing a transcervical DBC can be the primary method, or one of the alternative medical methods if the patient and/or obstetrician prefers not to conduct surgical operation [2]. DBC are commonly used for cervical ripening to induce labor with and without prior cesarean section in term [18,19].…”

“…Besides, ultrasound examination is normally performed at the 20 + 0 to 24 + 6 weeks of gestation to screen for structural abnormalities [1]. After learning about severe fetal abnormalities and their poor prognosis, most families will choose to terminate pregnancy in mid-trimester [2]. Induction of labor is a common obstetric intervention that occurs in a high proportion of pregnancies [3].…”

“…Dilation and evacuation procedures (D&E) are more common methods in the United States. In contrast, medical methods such as mifepristone plus with misoprostol, are more common in the United Kingdom, Europe and developing countries [2,4]. In our country, the common approach for induction of labor in mid-trimester pregnancy is to use pharmacological and mechanical devices.…”