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Foley balloon catheter versus Oral Misoprostol for Induction of Labour after Prelabour Rupture of Membranes: A Retrospective Data Analysis

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Open Journal of Obstetrics and Gynecology 2022年第7期12卷 579-589页

作者： Anna Bouwknegt Sjuul Jongen Kim Kamphorst Maria G. van Pampus Paul J. Q. van der Linden Joost J. Zwart Department of Obstetrics and Gynaecology Deventer Hospital Deventer The Netherlands Department of Obstetrics and Gynaecology OLVG Hospital Amsterdam The Netherlands

Objectives: The Foley balloon catheter (FC) is a viable method for cervical ripening, but concerns about infection risk restrict its use in cases of prolonged prelabour rupture of membranes (PROM). This study aims to evaluate the efficacy and safety of the FC compared to oral misoprostol for cervical ripening after PROM. Study Design: A retrospective data-analysis of 128 pregnant women was conducted. Of these, 49 underwent cervical ripening with an FC and 79 with oral misoprostol. We included all women with a vital singleton pregnancy at 37 - 42 weeks of gestation who underwent cervical ripening after ≥ 24 hours of PROM in specific time frames in two Dutchsecondary care and teaching hospitals. The primary outcome was the incidence of intrapartum infection, a composite of maternal and neonatal infection. In addition, we evaluated the mode of delivery, duration of priming and priming-to-delivery interval. Secondary endpoints included uterine hyperstimulation, umbilical cord prolapse, birth weight, Apgar scores, length of admission to the neonatal low dependency unit, admission to the (neonatal) Intensive Care Unit (ICU) and mortality. Statistical analyses included bivariate and multivariate techniques. Results: Cervical ripening with FC, compared with oral misoprostol, showed a higher incidence of intrapartum infection, respectively 32.7% (n = 16) vs. 12.7% (n = 10) (p = 0.006). However, after adjusting for epidural anaesthesia and pregestational BMI, the association was no longer significant. No difference was found in mode of delivery and total priming-to-delivery interval (median 21.3 hours vs. 22.0, p = 0.897). Furthermore, FC, compared with oral misoprostol, showed a longer duration of cervical ripening and hence a shorter duration of active labour (p 0.001). Apart from the 1-min Apgar score, secondary maternal and neonatal outcomes did not differ between the groups. Conclusion: In women who require cervical ripening after prolonged PROM at term, the FC and oral

关键词： Prelabour Rupture of Membranes (PROM) balloon catheter Misoprostol Cervical Ripening Labour Induction Chorioamnionitis

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Clinical usefulness of transpapillary removal of common bile duct stones by frequency doubled double pulse Nd:YAG laser

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World Journal of Gastroenterology 2008年第18期14卷 2863-2866页

作者： Tae Hyeon Kim Hyo Jeong Oh Chang-Soo Choi Dong Han Yeom Suck Chei Choi Department of Internal Medicine and Digestive Disease Research Institute Wonkwang University School of Medicine Iksan 570180 Korea

AIM: To study the efficacy and the safety of laser lithotripsy without direct visual control by using a balloon catheter in patients with bile duct stones that could not be extracted by standard technique. METHODS: The seventeen patients (7 male and 10 female; mean age 67.8 years) with difficult common bile duct (CBD) stones were not amenable for conventional endoscopic maneuvers such as sphincterotomy and mechanical lithotripsy were included in this study. Laser wavelengths of 532 nm and 1064 nm as a double pulse were applied with pulse energy of 120 mJ. The laser fiber was advanced under fluoroscopic control through the ERCP balloon catheter. Laser lithotripsy was continued until the fragment size seemed to be less than 10 mm. Endoscopic extraction of the stones and fragments was performed with the use of the Dormia basket and balloon catheter. RESULTS: Bile duct clearance was achieved in 15 of 17 patients (88%). The mean number of treatment sessions was 1.7 ± 0.6. Endoscopic stone removal could not be achieved in 2 patients (7%). Adverse effects were noted in three patients (hemobilia, pancreatitis, and cholangitis). CONCLUSION: The Frequency Doubled Double Pulse Nd:YAG (FREDDY) laser may be an effective and safe technique in treatment of difficult bile duct stones.

关键词： Bile duct stones Frequency doubled double pulse Nd:YAG laser Transpapillary removal Mechanical lithotripsy balloon catheter

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Vascular complications following prophylactic balloon occlusion of the internal iliac arteries resolved by successful interventional thrombolysis in a patient with morbidly adherent placenta

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2017年第3期18卷 272-276页

作者： Ning ZHANG Wei-hua LOU Xue-bin ZHANG Jia-ning FU Yun-yan CHEN Zhi-guo ZHUANG Jian-hua LIN Department of Obstetrics and Gynecology Renji Hospital School of Medicine Shanghai Jiao Tong University Shanghai 200126 China Department of lnterventional Oncolog Renji Hospital School of Medicine Shanghai Jiao Tong University Shanghai 200126 China Columbia Center for Translational Immunology Columbia University Medical Center New York NY 10032 USA Department of Radiology Renji Hospital School of Medicine Shanghai Jiao Tong University Shanghai 200126 China

The increasing incidence of morbidly adherent placenta （MAP） is placing women at a higher risk of life-threatening massive hemorrhage. The involvement of interventional radiology to manage this complex condition by performing prophylactic lilac artery balloon occlusion has been reported recently. However, the effectiveness and safety of this technique have not been fully determined. Here we report the case of a 25-year-old woman with placenta increta with preemptive bilateral internal lilac artery balloons who had external lilac artery thrombosis detected by computed tomography angiography （CTA） 72 h post cesarean section. A digital subtraction angiogram （DSA） and intra-arterial thrombolysis were instantly performed followed by supplementary conservative treatments, leading to a desirable resolution, of thrombus without sequela. This is the first report of vascular complications with successful interventional thrombolysis in this setting. Our experience suggests that prophylactic lilac artery balloon occlusion should be used cautiously in cases of MAP and consideration given to minimizing vascular complications given the hypercoagulable state of pregnancy.

关键词： balloon catheter Internal iliac artery Placenta accrete Vascular complication Interventional thrombolysis

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Cervical Ripening for Induction of Labor: A Randomized Comparison between Vaginal Misoprostol versus Foley’s catheter Placement in a Nigeria Tertiary Hospital

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Open Journal of Obstetrics and Gynecology 2021年第3期11卷 252-262页

作者： Matthew Igwe Nwali Joseph Agboeze Vitus Okwuchukwu Obi Arinze C. Ikeotuonye Ikechukwu Ogwudu Ugadu Emmanuel Ajuluchukwu Ugwa Department of Obstetrics and Gynecology Federal Teaching Hospital Abakaliki Nigeria Department of Obstetrics and Gynecology Federal Medical Center Birnin Kudu Nigeria

Background: Cervical ripening is prerequisite of successful induction of labor. Vaginal misoprostol and Foley’s catheter placement have been widely used for this purpose but the data are not always sufficient. We attempted to determine which (misoprostol versus Foley’s catheter) is more effective/safer in Nigerian setting. Methods: A randomized controlled trial was performed at Federal Teaching Hospital Abakaliki, Nigeria, involving 135 term pregnant women requiring cervical ripening and labor induction. Participants were randomly allocated to misoprostol versus catheter group. The following were recorded/measured/analyzed: Bishop’s score, age, parity, body mass index, gestational age, labor duration, indication, oxytocin use, mode of delivery, and Apgar score. Chi square test and t test were used where appropriate. Results: At 24 hours, all of misoprostol group were either in labor, had ripe cervix, or had delivered, whereas 35.4% of catheter group had still unripe cervix (x2 = 29.856, P = 0.0001). Misoprostol group was less likely to require oxytocin infusion (x2 = 52.600,

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