Umbilical cord presentation after use of a trans-cervical balloon catheter

作者：Yamada Takashi; Kataoka Soromon; Takeda Masamitsu; Kojima Takashi; Yamada Takahiro; Morikawa Mamoru; Tsuda Katsuya; Hanatani Kaoru; Yamaguchi Tatsumi; Minakami Hisanori

来源：Journal of Obstetrics and Gynaecology Research, 2013, 39(3): 658-662.

DOI：10.1111/j.1447-0756.2012.02008.x

• fetal malpresentation
• induction of labor
• trans-cervical balloon catheter
• umbilical cord descent
• umbilical cord prolapse

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 (20082009 for two hospitals and 20062009 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 70250mL 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 180250mL of saline was used, compared with when 70150mL of saline was used (8.2% [5/61] vs 0.15% [1/662], P%26lt;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 180250mL of saline increases the risk of cord presentation.

• 出版日期2013-3