Policiano Catarina, Pimenta Mariana, Martins Diana, Clode Nuno
Department of Obstetrics and Gynecology. Hospital Universitário de Santa Maria. Academic Medical Center of Lisbon. Lisbon. Portugal.
Department of Obstetrics and Gynecology. Hospital Beatriz Ângelo. Loures. Portugal.
Acta Med Port. 2017 Apr 28;30(4):281-284. doi: 10.20344/amp.8003.
Foley catheter promotes cervix priming by a direct mechanical effect of distension.
A prospective observational study was conducted at a tertiary hospital, including all cases of induction of labor with Foley catheter between September 1, 2013 and November 30, 2015. Women were eligible if they had a singleton pregnancy with a Bishop score < 6 and a gestational age ≥ 41 weeks or a medical indication for induction of labor. The primary outcome was the Bishop score variation (difference between Bishop score before and after insertion of Foley catheter). Mode of delivery, induction-to-delivery time, uterine tachysystole with fetal decelerations, peripartum fever ≥ 38º C, maternal pain and mortality were also analyzed.
Within 201 inductions with Foley catheter, average increase in Bishop score after catheter placement was three (1 - 7), with only 5% (11/201) of unmodified cervix after catheter removal/extrusion. Vaginal delivery rate was 71% (142/201) and in women with a previous cesarean section (n = 40) was 37% (15/40). Average induction-to-delivery time was 38 hours (4 - 120). Uterine infection rate was 3% (6/201). There was only one case of significant vaginal bleeding which required immediate catheter removal. There has been no significative maternal or neonatal morbidity.
DISCUSSION/CONCLUSION: Foley catheter is a safe and effective method of cervical priming for women with an unfavorable cervix, even in the case of a previous cesarean delivery.
福来导尿管通过扩张的直接机械作用促进宫颈准备。
在一家三级医院进行了一项前瞻性观察性研究，纳入了2013年9月1日至2015年11月30日期间所有使用福来导尿管引产的病例。如果妇女为单胎妊娠，Bishop评分<6且孕周≥41周或有引产的医学指征，则符合入选标准。主要结局是Bishop评分变化（插入福来导尿管前后Bishop评分的差值）。还分析了分娩方式、引产至分娩时间、伴有胎儿减速的子宫收缩过速、产后发热≥38ºC、产妇疼痛和死亡率。
在201例使用福来导尿管引产的病例中，放置导尿管后Bishop评分平均增加3分（1 - 7分），拔除/挤出导尿管后宫颈未改变的仅占5%（11/201）。阴道分娩率为71%（142/201），有剖宫产史的妇女（n = 40）阴道分娩率为37%（15/40）。引产至分娩的平均时间为38小时（4 - 120小时）。子宫感染率为3%（6/201）。仅有1例严重阴道出血病例，需要立即拔除导尿管。未出现明显的产妇或新生儿发病情况。
讨论/结论：对于宫颈条件不佳的妇女，即使是有剖宫产史的妇女，福来导尿管也是一种安全有效的宫颈准备方法。
