Objective: We evaluated the morbidity of Foley balloon for cervical ripening in comparison to oxytocin alone in women with a prior cesarean delivery.
Study Design: A four-hospital retrospective review of all women with viable singleton pregnancies and history of a single prior cesarean delivery presenting for cervical ripening between 1994 and 2015. Exposure groups were either Foley balloon or oxytocin, at the treating physician's discretion. The primary outcome was defined as maternal morbidity, evaluated by a composite that included hemorrhage, and/or uterine infection, and/or uterine rupture. We defined two secondary outcomes: neonatal morbidity, and vaginal delivery rate. Neonatal morbidity was evaluated by a composite that included five-minute APGAR score <7 and/or NICU admission. We adjusted results for potential confounding variables, including hospital site, maternal age and race, initial cervical dilation, and gestational age at delivery.
Results: We identified 688 patients who received ripening, 276 by Foley balloon and 412 by oxytocin. There was no significant difference in the primary outcome of maternal morbidity between groups: 38 (13.8%) in the Foley balloon group and 79 (19.2%) in the oxytocin group (aOR 1.43; 95% CI, 0.90-2.27). There was no significant difference in the secondary outcome of neonatal morbidity: 31 (11.3%) in the Foley balloon group and 51 (12.4%) in the oxytocin group (aOR 1.02; 95% CI, 0.57-1.80). The rate of vaginal delivery was significantly less in the Foley balloon group compared to the oxytocin group: 56.2% vs 64.1%, = .037.
Conclusion: When cervical ripening with either Foley balloon or oxytocin was utilized at the physician's discretion in women with prior cesarean, there was no identified difference in maternal and neonatal morbidity, but the rate of successful vaginal delivery was lower.
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http://dx.doi.org/10.1080/14767058.2020.1844653 | DOI Listing |
Ann Thorac Surg Short Rep
June 2024
Department of Cardiovascular Surgery, Iwate Prefectural Central Hospital, Morioka, Iwate, Japan.
Foley balloons have been used to secure emergency hemostasis for cardiac or vascular injuries since the 1960s. However, using a single large balloon may have drawbacks, such as insufficient hemostasis and blood flow impairment. We have encountered 3 major intraoperative laceration cases since 2011.
View Article and Find Full Text PDFBackground: Stone impaction is an obstacle to successful laparoscopic common bile duct exploration (LCBDE). This study aims to identify the incidence, operative difficulties and techniques used to disimpact and remove impacted stones during LCBDE.
Methods: Prospectively collected data from a large series of LCBDE.
Cureus
December 2024
Obstetrics, Orlando Regional Medical Center, Orlando, USA.
Eur J Obstet Gynecol Reprod Biol
December 2024
Dep. Obstetrics and Gynecology, Medical School, University of Lisbon, Portugal; CEAUL - Centro de Estatística e Aplicações, Faculdade de Ciências, Universidade de Lisboa, Portugal.
Objective: To evaluate whether the success rate of oral mifepristone was not inferior to that of Foley balloon catheter for outpatient cervical ripening of term pregnancies, and whether there were differences in side effects for mothers and newborns.
Design: Open-label, non-inferiority randomised controlled trial.
Setting: A tertiary care European university hospital in an urban setting.
This is the case of a 30-year-old nulliparous patient with a complete uterine septum, double cervix and non- obstructive longitudinal vaginal septum (Class U2bC2V1 according to the ESHRE/ESGE classification). The patient presented with severe dyspareunia and dysmenorrhea. Imaging revealed a complex Müllerian anomaly and hysteroscopic treatment was agreed.
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