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Resumen: Introduction: We analysed the efficacy and safety of double-balloon catheter for cervical ripening in women with a previous cesarean section and which were the most important variables associated with an increased risk of repeated cesarean delivery. Materials and methods: We designed an observational retrospective study of 418 women with unfavourable cervices (Bishop Score <5), a prior cesarean delivery, and induction of labour with a double-balloon catheter. Baseline maternal data and perinatal outcomes were recorded for a descriptive, bivariate, and multivariate analysis. A p value <0.05 was considered statistically significant. Results: Most women improved their initial Bishop Score (89.5%) although only a 20.8% of them went into spontaneous active labour. Finally, 51.4% of the women achieved a vaginal delivery. Five cases of intrapartum uterine rupture (1.2%) occurred. After multivariate analysis, main risk factors for repeated cesarean section were dystocia in the previous pregnancy (OR 1.744; CI 95% 1.066–2.846), the absence of previous vaginal delivery (OR 2.590; CI 95% 1.066–6.290), suspected fetal macrosomia (OR 2.410; CI 95% 0.959–6.054), and duration of oxytocin induction period (OR 1.005; CI 95% 1.004–1.006). The area under the curve was 0.789 (p < 0.001). Conclusions: Double-balloon catheter seems to be safe and effective for cervical ripening in women with a previous cesarean delivery and unfavourable cervix. In our study, most women could have a vaginal delivery in spite of their risk factors for cesarean delivery. A multivariate model based on some clinical variables has moderate predictive value for intrapartum cesarean section.
Idioma: Inglés
DOI: 10.1007/s00404-017-4343-7
Año: 2017
Publicado en: ARCHIVES OF GYNECOLOGY AND OBSTETRICS 295, 5 (2017), 1135-1143
ISSN: 0932-0067
Factor impacto JCR: 2.236 (2017)
Categ. JCR: OBSTETRICS & GYNECOLOGY rank: 34 / 81 = 0.42 (2017) - Q2 - T2
Factor impacto SCIMAGO: 0.956 - Medicine (miscellaneous) (Q1) - Obstetrics and Gynecology (Q2)

Tipo y forma: Artículo (Versión definitiva)
Área (Departamento): Área Obstetricia y Ginecología (Dpto. Cirugía,Ginecol.Obstetr.)

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