Foleys Catheter Combined With Dinoprostone Suppositories For The Induction Of Labor In Late Pregnancy

When a disease that threatens the health of mother and child occurs in late pregnancy,in order to improve the outcome of mother and child,it is necessary to use an artificial method to terminate the pregnancy prematurely.This is the induction of labor during the third trimester of pregnancy.It is reported that the current rate of induction of labor can reach 20% in European and American countries.The key to successful labor induction is the level of cervical maturity.With the increase of cervical maturity,the success rate of induced labor increases accordingly.Inducing uterine contraction before induction without sufficient cervical ripening may lead to misuse of oxytocin,increased maternal and child morbidity,and prolonged labor,and even lead to unsuccessful induction of labor,resulting in an increase in cesarean section rate and the average hospital stay will also be extended.The ideal method for cervical ripening should simulate the natural maturation process of the cervix,the purpose is not to cause excessive stimulation of the uterus,premature rupture of the membranes,and can not cause adverse effects on the next pregnancy.At present,there are two major types of clinically used late pregnancy to promote cervical ripening.One is the drug method,Including small doses of oxytocin and prostaglandin preparations(misprostol,controlled release dinoprostone suppositories).The other is mechanical stimulation methods,including catheter balloon,COOK balloon and so on.Low-dose oxytocin is a traditional method used to promote cervical ripening and induction,and its use alone is not effective.COOK balloon is expensive due to its limited clinical use.Urinary catheters have gradually increased in recent years.Controlled release of dinoprostone suppository(Xinpubeisheng)as a controlled release of new prostaglandin preparations,with significant clinical efficacy and safety,is the first choice for the induction of cervicalripening induction drugs in Europe and America.The application in our country is also more extensive.Objective:Induction of labor was performed for pregnant women who met the indications for induction of labor during the third trimester of pregnancy.Foleys Catheter Balloon Combined with Oxytocin and Foleys Catheters in Combination with dinoprostone suppositories Induced Labor.Comparing the two groups of data in the time of labor,the first stage of labor,the second stage of labor,the third stage of labor,the total time of labor,the mode of delivery,the outcome of labor and related complications such as whether the difference in whether the difference was statistically significant.To explore a relatively safe and effective method of induction of labor in order to increase the success rate of induction of labor,reduce the complications of childbirth,reduce the rate of cesarean section,shorten the average length of stay,reduce the cost of hospitalization,and improve the quality of obstetrics.Methods:To retrospectively analyze the clinical data of 86 pregnant women with indications of induction of labor during late pregnancy from December 2016 to December 2017 in our department of obstetric hospitalization.Inclusion criteria were:single living fetus,head position,first-time mothers,admission Bishop score ≤ 6points,indications for induction of labor,and no contraindication to induction of labor.Exclusion criteria: twin births or multiple births,maternal,unexplained vaginal bleeding,premature rupture of membranes,history of previous uterine or cervical surgery,cephalopelvic disproportion,reproductive tract inflammation and other labor induction contraindications.According to the different methods of inducing labor,they were divided into two groups.The observation group used Foleys catheterballoon in combination with Xinpubeisheng induction(48 cases),the control group used Foleys catheter balloon combined with oxytocin induction(38 cases).The maternal labor time,labor time,delivery methods,delivery outcomes and related complications were compared and analyzed.We compared and analyzed the labor time,labor time,delivery methods,delivery outcomes and related complications of the two groups of women.Results:1.The Foleys catheter balloon combined with the dinoprostone suppositories group was shorter than the Foleys catheter plus oxytocin group in terms of labor time,first stage of labor,second stage of labor and total labor.The difference was statistically significant(P< 0.05).There was no significant difference between the two groups in the third stage of labor.2.The ratio of Foleys ureterocyst plus the dinoprostone suppositories group to vaginal delivery was 87.5%,the rate of transit cesarean section was 12.5%,and the ratio of Foleys catheter to oxytocin group was 68.4%.The proportion of transit cesarean section was 31.6%;P<0.05,the difference was statistically significant.3.In the case of cervical laceration,the proportion of dinoprostone suppositories group was more than that of oxytocin group(P<0.05).The difference was statistically significant.4.There was no statistically significant difference between the two groups of data in the causes of transit cesarean section(P>0.05).5.There was no significant difference in the proportion of vaginal midwifery between the two groups of data.6.There was no significant difference in complications,neonatal body weight,Apgar score,and postpartum hemorrhage between the two groups(P>0.05).Conculusions:1.The Foleys catheter balloon combined with the dinoprostone suppositories induction can effectively shorten labor time,the first stage of labor,the second stage of labor and the total time of labor,reduce the rate of cesarean section,and improve vaginal delivery rate.2.There may be uterine contractions in the induction process of the foleys catheter balloon combined with the dinoprostone suppositories.When using dinoprostone suppository,it should strengthen monitoring,prepare for delivery in advance,fully protect the perineum,and carefully check the soft birth canal after birth.,handle the bad situation in time.3.The Foleys catheter balloon combined with the dinoprostone suppositories suppository for pregnant women with low cervical score in the third trimester induction effect,simple operation,safe and reliable,it is worth further promotion.