RESUMEN
OBJECTIVE: To compare the efficacy and safety of the use of transcervical Foley's catheter versus Cook cervical ripening balloon in pregnant women with stillbirth, unfavorable cervix and scarred uterus. DESIGN: Randomized controlled study. SETTING: El Minia University Hospital, El Minia, Egypt. PATIENTS AND METHODS: Two-hundred pregnant women with stillbirth, unfavorable cervix and scarred uterus were recruited into this study. They were randomized into two groups. In group I (n = 100), cervical ripening was done using Foley's catheter. In group II (n = 100), cervical ripening was done using Cook cervical ripening balloon. MAIN OUTCOME MEASURES: Balloon insertion to delivery interval, successful ripening rate, cesarean delivery rate, maternal adverse events and maternal satisfaction. RESULTS: Time from balloon insertion to expulsion and from balloon insertion to delivery was significantly shorter in Foley's catheter group. However, the difference between the two groups regarding time from balloon insertion to active labor, time from balloon expulsion to delivery, cervical ripening, cesarean section, instrumental delivery, pain score, need for analgesia, hospital stay and maternal satisfaction was not statistically significant. CONCLUSIONS: Foley's catheter and Cook cervical ripening balloon are comparable regarding efficacy and safety profile when used to ripen the cervix in pregnant women with stillbirth, unfavorable cervix and scarred uterus. However, Foley's catheter has a shorter induction to delivery interval and is relatively cheaper device.
Asunto(s)
Maduración Cervical , Cuello del Útero/patología , Parto Obstétrico/instrumentación , Mortinato , Cateterismo Urinario/métodos , Útero/patología , Administración Intravaginal , Adulto , Cicatriz , Egipto , Femenino , Humanos , Trabajo de Parto Inducido/métodos , Complicaciones del Trabajo de Parto , Embarazo , Adulto JovenRESUMEN
OBJECTIVE: To monitor femoral artery blood flow by Doppler velocimetry in women treated for postpartum hemorrhage (PPH) with and without the adjunction of the External Aortic Compression Device (EACD), and to assess the possible adverse effects of the device. METHODS: Blood flow velocity in the femoral artery, as well as skin color and sensory or motor changes in the lower limbs, were assessed in 120 women with primary PHH of any cause, quasi randomized to either treatment group. Pulse rate, oxygen saturation, respiratory rate, urinary output, and gastrointestinal symptoms were checked in the study group. RESULTS: While blood flow velocity was significantly less in the study group than control group (P<0.001), the lowest flow volume velocity of 310.40 mL/sec exceeded the acceptable minimum after device application. The intensity of abdominal discomfort correlated with body mass index. No device complications were observed. CONCLUSION: The EACD contributed safely and effectively to the treatment of 60 women with PPH of different causes.