1.Methods differences for cervical ripening and induction of labour study
Chinzorig B ; Dondogdorj D ; Battulga G ; Munkhtsetseg D
Mongolian Journal of Obstetrics, Gynaecology and Pediatrics 2020;28(2):2034-2040
Methods differences for cervical ripening and induction of labour study
Background: According to the World Health Organization review, the use of induction of labour methods varies from country to country. In 2010, meta-analysis study showed that the folley balloon catheter had less complications of uterine contraction compared with local prostaglandins, and there was no difference in Cesarean section. In Mongolia we use two different guidelines of cervical ripening for labour induction. Further, other methods required into our induction of labour medical service.
Materials and methods: Cross sectional prospective and analytical research done. The results of the survey were taken from a specially developed questionnaire and the results were analyzed using SPSS-16 software. The study population was selected for non-probability and targeted sampling.
Results: The mean time to insert the balloon catheter was 8.33±7.22 hours. 62(79.5%) of the balloon catheters were spontaneously pushed out of the cervix, labor was stimulated at 62(79.5%), 60(78.9%) were born within 24 hours of preparation for delivery, and the average time of birth within 24 hours was 17.03±18.56 hours, 54(69.2%) of the mothers gave birth by caesarean section, 4(5.1%) by vacuum, and 20(25.6%) by caesarean section. To assess the effect of inflated balloon catheter preparation on the preparation of the cervix, saline solution 20ml (25.6%), 80ml 16(20.5%), 100ml 14(17.9%), and 150ml 26(35.9%) female balloon catheters were used. Inflating to 60ml was statistically more significant (p<0.004) than inflating. CTG has been shown to be more altered when oxytocin is induced by misoprostol-induced labor. The assessment of CTG at birth was 24(18.2%) in the oxytocin-induced group, 2(3.6%) in the misoprostol-induced group, 4(28.61%) in the folic catheter-induced group, and 12(40%) in the misoprostol-induced oxytocin group, a statistically significant correlation (p<0.0001) occurred in 8(15.4%) women who received oxytocin induced by folic catheter delivery. There was a statistically significant correlation between the occurrence of tachystole in the 3 postpartum groups and the occurrence of oxytocin and folate catheters in 6(10%) women in the misoprostol-induced group (p<0.031). In the folate-catheter-induced group, the duration of labor was 3 to 5 hours longer than in the oxytocin and misoprostol-induced groups, which was statistically significant (p<0.0001), compared with 5.3±1.9 hours in the oxytocin-induced group and 7.4±2.4 hours in the misoprostol-induced group, 10.4±4.3 hours in the foley-catheter-induced group.
Conclusions: In preparing the cervix for childbirth, inflating the balloon catheter with 60 ml of saline is of clinical statistical significance. Continued use of oxytocin to prepare the cervix for delivery with a balloon catheter increases the chances of delivery. Preparation of the cervix for delivery with a balloon catheter is less common than tachysystole with misoprostol. Preparing the cervix for delivery with a balloon catheter is less likely to cause CTG changes than misoprostal.
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