剖宫产后使用 Foley 导管引产与自然发动分娩的比较：一项队列研究
Induction of labor by Foley catheter compared with spontaneous onset of labor after previous cesarean section: a cohort study.
作者信息
Kruit H, Wilkman H, Tekay A, Rahkonen L
机构信息
Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Faculty of Medicine, University of Helsinki, Helsinki, Finland.
出版信息
J Perinatol. 2017 Jul;37(7):787-792. doi: 10.1038/jp.2017.50. Epub 2017 Apr 13.
OBJECTIVE
To evaluate the safety of induction of labor (IOL) with Foley catheter (FC) in women with a history of previous cesarean section (CS) and to assess risk factors for repeat CS and adverse maternal outcomes.
STUDY DESIGN
Cohort study of 1559 women with a history of previous CS in Helsinki University Hospital, Finland between 2013 and 2014.
RESULTS
Three hundred and sixty-one women (23.2%) underwent IOL by FC and 1198 (76.8%) had spontaneous onset of labor. The rate of repeat CS was higher in women undergoing IOL (38% vs 20.2%; P<0.001). The overall rate of uterine rupture was 0.3% in induced labor and 0.8% in spontaneous onset of labor (P=0.47). Adverse maternal outcomes were not significantly different. The intrapartum and postpartum infection rates were higher in women undergoing IOL compared with spontaneous onset of labor (6.1% vs 1.8%; P>0.001 and 5.3% vs 1.3%; P<0.001, respectively).
CONCLUSION
FC appears safe and effective method for IOL in women with a history of previous CS.
目的
评估在有剖宫产史的女性中使用福乐导尿管（FC）引产的安全性，并评估再次剖宫产及产妇不良结局的危险因素。
研究设计
对2013年至2014年期间芬兰赫尔辛基大学医院的1559例有剖宫产史的女性进行队列研究。
结果
361例（23.2%）女性通过FC引产，1198例（76.8%）自然发动分娩。引产女性的再次剖宫产率更高（38%对20.2%；P<0.001）。引产时子宫破裂的总体发生率为0.3%，自然发动分娩时为0.8%（P=0.47）。产妇不良结局无显著差异。与自然发动分娩相比，引产女性的产时和产后感染率更高（分别为6.1%对1.8%；P>0.001和5.3%对1.3%；P<0.001）。
结论
对于有剖宫产史的女性，FC似乎是一种安全有效的引产方法。
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