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Objective:To evaluate the efficacy of three kinds of uterine barriers: cook balloon, Foley balloon and intrauterine devices in preventing re-adhesion after separation of moderate or severe intrauterine adhesions.Methods:Seven databases including PubMed, Embase, Medline, Cochrane Library, China HowNet, Wanfang and CQVIP were used to retrieve, and the randomized controlled trials on the effect of using COOK balloon, Foley balloon and intrauterine devices to prevent re-adhesion after the separation of moderate and severe intrauterine adhesions were collected from the establishment of the database to December 2021. Revman 5.1 software was used for Meta analysis.Results:A total of 16 articles were selected according to the inclusion criteria. Meta analysis results showed that the rates of preventing postoperative re-adhesion, improving menstruation and pregnancy in COOK balloon were significantly better than those in intrauterine devices ( OR = 0.31, 2.75 and 1.58; 95% CI 0.19 to 0.49, 1.74 to 4.35 and 1.07 to 2.34; P<0.01); the rates of preventing postoperative re-adhesion, improving menstruation and pregnancy in Foley balloon were significantly better than those in intrauterine devices ( OR = 0.39, 1.90 and 1.73; 95% CI 0.27 to 0.57, 1.33 to 2.71 and 1.02 to 2.39; P<0.01 or <0.05). Conclusions:The use of COOK balloon and Foley balloon to prevent adhesion is better than the use of intrauterine devices in preventing re-adhesion in patients with moderate or severe intrauterine adhesions.
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ObjectiveTo investigate the effect of COOK balloon placement time on the efficacy of severe intrauterine adhesions.Methods150 patients with severe IUA were prospectively enrolled and randomized divided into three short-term group, medium-term group and long-term group, with respectively balloon placement time 1 week, 1 month and 2 months. All subjects underwent transcervical resection of adhesion (TCRA). Re-adhesion and pregnancy rate after treatment, the relevant infection indicators, uterine cavity recovery, AFS score improvement rate, menstrual improvement, and endometrial thickness were analyzed.ResultsAll patients underwent transcervical resection of adhesion (TCRA) and COOK balloon placement successfully. Improvement of pregnancy rate and first pregnancy time were observed in group B and C than group A (P0.05).ConclusionPlacement of the uterine COOK balloon for more than 1 month may improve uterine cavity, pregnancy rate, AFS score, menstruation and endometrial thickness. However, the risk of infection increased at the second month after COOK balloon placement.
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ObjectiveTo investigate the effect of COOK balloon placement time on the efficacy of severe intrauterine adhesions.Methods150 patients with severe IUA were prospectively enrolled and randomized divided into three short-term group, medium-term group and long-term group, with respectively balloon placement time 1 week, 1 month and 2 months. All subjects underwent transcervical resection of adhesion (TCRA). Re-adhesion and pregnancy rate after treatment, the relevant infection indicators, uterine cavity recovery, AFS score improvement rate, menstrual improvement, and endometrial thickness were analyzed.ResultsAll patients underwent transcervical resection of adhesion (TCRA) and COOK balloon placement successfully. Improvement of pregnancy rate and first pregnancy time were observed in group B and C than group A (P0.05).ConclusionPlacement of the uterine COOK balloon for more than 1 month may improve uterine cavity, pregnancy rate, AFS score, menstruation and endometrial thickness. However, the risk of infection increased at the second month after COOK balloon placement.
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Objective To explore the clinical effects of single-cavity and COOK cervical ripening balloon in promoting full-term pregnancy cervical mature and inducing labour. Methods 126 puerpera who were expect-ant in the obstetrics department of our hospital were selected from January 2016 to June 2017,and all of the puer-pera were induced labor by cervical ripening balloon.In 61 of them,single-cavity balloon was used,and 65 cases were induced labor by COOK balloon. Determining the cervical ripening situation,the time needed for inducing efficient uterine contraction,the first stage of labor time,the total labor time,vaginal delivery rate,natural labor situation,postpartum hemorrhage,amniotic fluid turbidity,puerperal infection and newborn asphyxia of the two groups.Results the time needed for inducing efficient uterine contraction of the two groups were(16.39±2.68)h, (14.54 ± 3.30)h,and the two groups were statistically different(P<0.05).There were no statistically significant differences in other items of two groups(P>0.05).Conclusion single-cavity balloon and COOK balloon are sim-ilar in promoting full-term pregnancy cervical ripening.The difference is that the time needed for inducing efficient uterine contraction of the single-cavity balloon is longer than COOK balloon,but have no adverse effect to the puer-pera and the newborn.Both types of balloons are recommended to be used in promoting full-term pregnancy cervical ripening and inducing labor.
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<p><b>INTRODUCTION</b>Evidence has shown that balloon catheters are as effective as prostaglandins (PGE) in achieving vaginal delivery within 24 hours of the start of induction of labour (IOL), with lower rates of uterine hyperstimulation, and similar Caesarean section and infection rates. International guidelines recommend mechanical methods as a method of IOL. We designed a prospective randomised controlled study to evaluate patient acceptance of the cervical ripening balloon (CRB) for IOL.</p><p><b>METHODS</b>Suitable women with a singleton term pregnancy without major fetal anomaly suitable for vaginal delivery were recruited and randomised to receive the CRB or PGE on the day of IOL. Characteristics of the women, labour and birth outcomes were obtained from case notes. Pain and satisfaction scores were obtained by interviewing the women at IOL and after delivery. The main outcome measures were participant characteristics, labour and birth outcomes, pain score, satisfaction scores, and whether the participant would recommend the mode of IOL.</p><p><b>RESULTS</b>There was no difference in the pain score between the two groups at the start of IOL, but thereafter, pain scores were lower in the CRB group compared to the PGE group (4.5 ± 2.3 vs. 5.6 ± 2.4, p = 0.044). Women were equally satisfied with both methods and equally likely to recommend their method for IOL.</p><p><b>CONCLUSION</b>Patient experience of IOL with CRB or PGE was equally satisfactory, although pain during induction was lower in the CRB group. We found that both methods of IOL are acceptable to women and should be made available to provide more options.</p>