Umbilical cord presentation after use of a trans-cervical balloon catheter.
Summary of "Umbilical cord presentation after use of a trans-cervical balloon catheter."
AIM:
To examine the incidence of umbilical cord presentation, including cord prolapse (UCP) and cord descent (UCD), after the use of a trans-cervical balloon catheter (TCBC), such as a Foley catheter and a metreurynter, for the induction of labor (IOL).
METHODS:
A retrospective medical chart review was conducted, focusing on the occurrence of UCP and UCD in 800 women who underwent IOL with a TCBC at five hospitals during the study period (2008-2009 for two hospitals and 2006-2009 for three hospitals). The five hospitals had a total of 8245 deliveries during the study period. UCP and UCD were defined as the descent of the umbilical cord in advance of the presenting fetal part in the presence and absence of rupture of fetal membranes, respectively.
RESULTS:
The frequency of IOL using a TCBC with 70-250 mL of saline varied among the five hospitals from 4.9% to 18.8% (mean ± SD, 10.7 ± 5.0%). UCP and UCD occurred in two and four women, respectively, with the frequency of cord presentation varying among the hospitals from 0.0% to 1.8% (mean ± SD, 0.9 ± 0.9%); the cord presentation was significantly more likely to occur when 180-250 mL of saline was used, compared with when 70-150 mL of saline was used (8.2% [5/61] vs 0.15% [1/662], P < 0.0001). A change in the presenting fetal body part also occurred in 0.5% (4/800) of the women.
CONCLUSION:
The use of a TCBC with 180-250 mL of saline increases the risk of cord presentation.
Affiliation
Department of Obstetrics, Hokkaido University Graduate School of Medicine, Sapporo.
Journal Details
This article was published in the following journal.
Name: The journal of obstetrics and gynaecology research
ISSN: 1447-0756
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/23003562
- DOI: http://dx.doi.org/10.1111/j.1447-0756.2012.02008.x
Medical and Biotech [MESH] Definitions
Umbilical Veins
Venous vessels in the umbilical cord. They carry oxygenated, nutrient-rich blood from the mother to the FETUS via the PLACENTA. In humans, there is normally one umbilical vein.
Catheterization, Swan-ganz
Placement of a balloon-tipped catheter into the pulmonary artery through the antecubital, subclavian, and sometimes the femoral vein. It is used to measure pulmonary artery pressure and pulmonary artery wedge pressure which reflects left atrial pressure and left ventricular end-diastolic pressure. The catheter is threaded into the right atrium, the balloon is inflated and the catheter follows the blood flow through the tricuspid valve into the right ventricle and out into the pulmonary artery.
Balloon Occlusion
Use of a balloon catheter to block the flow of blood through an artery or vein.
Umbilical Arteries
Specialized arterial vessels in the umbilical cord. They carry waste and deoxygenated blood from the FETUS to the mother via the PLACENTA. In humans, there are usually two umbilical arteries but sometimes one.
Angioplasty, Balloon, Coronary
Dilation of an occluded coronary artery (or arteries) by means of a balloon catheter to restore myocardial blood supply.
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