He Yun, Tao Yu, Ni Qin, Li Zhuoyue, Huang Ying, Liu Lanhua
Department of Obstetrics and Gynecology, Taixing People's Hospital, Taixing, China.
Medicine (Baltimore). 2024 Dec 20;103(51):e41068. doi: 10.1097/MD.0000000000041068.
The timing of amniotomy after the Foley balloon catheter removal is crucial for successful labor induction. This study aimed to assess the effects of the Bishop score on the timing of amniotomy in patients undergoing labor induction after the Foley balloon catheter removal. This was a retrospective cohort study based on electronic medical records. We performed a Chester sampling in patients with singleton-term pregnancies who initially underwent cervical ripening using a Foley balloon catheter at the Obstetrical Department of Taixing People's Hospital from January 2023 to July 2023. A total of 889 patients were admitted to the study. After excluding 330 patients according to the exclusion criteria, 103 patients were included. Following the Foley balloon removal, an amniotomy with a Bishop score < 6 was defined as an amniotomy with an unfavorable Bishop score (n = 62), and an amniotomy with a Bishop score ≥ 6 was defined as an amniotomy with a favorable Bishop score (n = 41). The primary outcome was the incidence of cesarean delivery and the interval from induction to delivery. The secondary outcomes included the incidence of operative vaginal delivery, intrapartum hemorrhage, postpartum hemorrhage, infection, thrombosis, and neonatal outcomes. All statistical comparisons were analyzed by GraphPad Prism 9. All data were presented as the mean ± SD or percentage. Statistical analysis comparing both groups was performed using the t test, chi-square test, or Fisher exact test where appropriate. The baseline data, operative vaginal delivery rate, postpartum hemorrhage rate, infection rate, thrombosis rate, intrapartum and postpartum hemorrhage volume, and neonatal outcomes showed no significant differences between the 2 groups. However, the cesarean delivery rate, interval from induction to delivery, and hemoglobin postdelivery decline were significantly decreased in the favorable Bishop score group. Amniotomy with a favorable Bishop score after Foley balloon catheter removal is linked to lower cesarean delivery rates, shorter induction-to-delivery intervals, and less postdelivery hemoglobin decline without increasing adverse maternal or neonatal outcomes.
拔除 Foley 球囊导管后羊膜腔穿刺的时机对于成功引产至关重要。本研究旨在评估 Bishop 评分对拔除 Foley 球囊导管后引产患者羊膜腔穿刺时机的影响。这是一项基于电子病历的回顾性队列研究。我们对 2023 年 1 月至 2023 年 7 月在泰兴市人民医院产科最初使用 Foley 球囊导管进行宫颈成熟的单胎足月妊娠患者进行了整群抽样。共有 889 例患者纳入研究。根据排除标准排除 330 例患者后，纳入 103 例患者。拔除 Foley 球囊导管后，Bishop 评分<6 的羊膜腔穿刺定义为 Bishop 评分不利的羊膜腔穿刺（n = 62），Bishop 评分≥6 的羊膜腔穿刺定义为 Bishop 评分有利的羊膜腔穿刺（n = 41）。主要结局是剖宫产率以及引产至分娩的间隔时间。次要结局包括手术助产率、产时出血、产后出血、感染、血栓形成以及新生儿结局。所有统计比较均采用 GraphPad Prism 9 进行分析。所有数据均以均值±标准差或百分比表示。在适当情况下，使用 t 检验、卡方检验或 Fisher 精确检验对两组进行统计学比较。两组之间的基线数据、手术助产率、产后出血率、感染率、血栓形成率、产时和产后出血量以及新生儿结局均无显著差异。然而，Bishop 评分有利组的剖宫产率、引产至分娩的间隔时间以及产后血红蛋白下降幅度均显著降低。拔除 Foley 球囊导管后 Bishop 评分有利的羊膜腔穿刺与较低的剖宫产率、较短的引产至分娩间隔时间以及较少的产后血红蛋白下降相关，且不会增加孕产妇或新生儿不良结局的发生率。
