Bouwknegt, Anna (2020) Foley balloon catheter comparable to oral misoprostol in women with prolonged prelabour rupture of membranes at term A retrospective data analysis. thesis, Medicine.
Full text available on request.Abstract
Background: Prolonged prelabour rupture of membranes (PROM) is associated with significant maternal and neonatal infectious morbidity. The optimal management of PROM however, remains controversial. Although an abundance of studies supports use of the Foley balloon catheter (FC) for cervical ripening in women with intact amniotic membranes, little is known about the effects of the FC after PROM. The aim of this study was to evaluate the efficacy and safety of the FC for cervical ripening after prolonged PROM, by comparing it with the administration of oral misoprostol. Methods: A retrospective data analysis in two Dutch teaching hospitals regarding women with ≥ 24 hours of PROM at term and an unfavourable cervix was conducted. Routine care for cervical ripening was performed using a FC or oral misoprostol. The primary outcome was the incidence of intrapartum infection, a composite of maternal and neonatal infection. Results: We included 128 women with prolonged PROM. Of these, 49 underwent cervical ripening with a FC and 79 received oral misoprostol. The incidence of intrapartum infection was higher in the FC group as compared to oral misoprostol, 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. Moreover, no significant difference was found in mode of delivery. Whereas the priming-to-delivery interval was similar (median 21.3 hour vs. 22.0, p = 0.897), the duration of priming was significantly longer in the FC group (median 16.6 vs. 11.5 hours, p = 0.042). Conclusions: In women who require cervical ripening after prolonged PROM at term, FC and oral misoprostol are similar in terms of safety and efficacy.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Zwart, Dr. J.J. and van der Linden, Dr. P.J.Q. |
| Faculty: | Medical Sciences |
| Date Deposited: | 29 Aug 2023 11:50 |
| Last Modified: | 29 Aug 2023 11:50 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3654 |
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