Background: One in four Australian births are induced. If cervical ripening using a prostaglandin is required, a pre-labour overnight hospitalisation and separation from family and support companions is necessary. Recent evidence shows that balloon catheter cervical ripening is just as effective as prostaglandins, but does not cause uterine stimulation. For women with low risk pregnancies, this offers the possibility of undergoing the overnight ripening process in their own home. We conducted a pilot randomised trial to assess the outcomes, clinical pathways and acceptability to both women and clinicians of outpatient balloon catheter ripening compared with usual inpatient care.
Methods: Forty-eight women with low risk term pregnancies were randomised (2:1) to either outpatient (n = 33) or inpatient double-balloon catheter (n = 15) cervical ripening. Although not powered for statistically significant differences, the study explored potential direction of effect for key clinical outcomes such as oxytocin use, caesarean section and morbidities. Feedback on acceptability was sought from women at catheter insertion and 4 weeks after the birth, and from midwives and doctors, at the end of the study.
Results: Clinical and perinatal outcomes were similar. Most women required oxytocin (77 %). The outpatient group were 24 % less likely to require oxytocin (risk difference -23.6 %, 95 % CI -43.8 to -3.5). There were no failed inductions, infections or uterine hyperstimulation attributable to the catheter in either group. Most women in both groups reported discomfort with insertion and wearing the catheter, but were equally satisfied with their care and felt the baby was safe (91 % both groups). Outpatient women reported feeling less isolated or emotionally alone. Most midwives and doctors (n = 90) agreed that they are more comfortable in sending home a woman with a catheter than prostaglandins and 90 % supported offering outpatient ripening to eligible women.
Conclusions: Outpatient balloon catheter ripening should be further investigated as an option for women in an adequately powered randomised trial.
Trial Registration: Prospectively registered, Australian New Zealand Clinical Trials Registry ACTRN12612001184864 .
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4450858 | PMC |
| http://dx.doi.org/10.1186/s12884-015-0550-z | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The guide extension-facilitated ostial stenting (GEST) technique uses a guide extension catheter (GEC) to improve stent delivery during primary coronary angioplasty (PCI). GECs are used for stent delivery into the coronary arteries of patients with difficult anatomy due to tortuosity, calcification, or chronic total occlusion (CTO) vessels. Stent and balloon placement has become challenging in patients with increasing lesion complexity due to tortuosity, vessel morphology, length of the lesion, and respiratory movements.
View Article and Find Full Text PDFAmniotic Fluid Embolism After Cervical Ripening.
Cureus
December 2024
Obstetrics, Orlando Regional Medical Center, Orlando, USA.
Article Synopsis
- Amniotic fluid embolism (AFE) is a rare but severe complication during childbirth that can lead to rapid failure of multiple organ systems and significant maternal mortality.
- A case study involving a 31-year-old woman induced for labor revealed AFE's unpredictability, as she developed sudden fetal distress and hypoxia, leading to an emergency cesarean delivery.
- Despite the high mortality associated with AFE, both the mother and the infant survived and were doing well six months later, highlighting the importance of prompt diagnosis and treatment options like the "A-OK" protocol.
Enhanced Efficiency of Sequential Cutting Balloon Angioplasty in Calcified Coronary Artery Disease: The RODIN-CUT Technique.
Catheter Cardiovasc Interv
January 2025
HartCentrum Ziekenhuis Aan de Stroom (ZAS) Middelheim, Antwerp, Belgium.
Article Synopsis
- Heavily calcified coronary artery disease complicates percutaneous coronary intervention (PCI), requiring advanced techniques like cutting balloons (CB), which need standardization for better effectiveness.
- The study presents the RODIN-CUT technique, which involves sequential CB inflations guided by intravascular ultrasound (IVUS) to improve plaque modification and stent expansion in difficult cases.
- Results indicate that RODIN-CUT achieved high procedural success rates and minimal complications, suggesting it could be a simple and cost-effective method for treating calcified lesions, though larger studies are needed to confirm its validity.
Paclitaxel-Coated Balloon for the Management of In-Stent Coronary Restenosis: An Updated Meta-Analysis and Trial Sequential Analysis.
Catheter Cardiovasc Interv
January 2025
Department of Medicine, Federal University of Goiás, Goiânia, Brazil.
Background: Drug-coated balloons present a potentially advantageous therapeutic approach for managing coronary in-stent restenosis (ISR). However, the comparative benefits of paclitaxel-coated balloons (PCBs) over uncoated balloons (UCBs) remain unclear.
Aims: We conducted a systematic review and meta-analysis to evaluate and compare the clinical outcomes of patients treated with PCBs and UCBs.
Article Synopsis
- The "no-touch" technique allows for safe navigation of a guiding catheter during carotid artery stenting, especially in patients with complicated arterial lesions.
- A specially designed 4-Fr Newton-shaped catheter minimizes contact with stenotic lesions while advancing to the target area.
- In a study of eight procedures, this technique was successful in all cases, showing it can be effective for patients with tortuous anatomy and floating thrombi without causing complications.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!