ABSTRACT
A retrospective study to determine the risks of normal delivery after cesarean section, was done. The inclusion criteria were found in 116 patients in six years covering the study. All the patients were permitted normal delivery and none received ocitocin. Sixty six patients accomplished delivery, which corresponds to 57%. In the rest of patients cesarean section was performed. The probability of ending in delivery was associated to women with three or more gestas. But cephalo-pelvic disproportion and fetal suffering, were associated to greater probability of ending in cesarean section. There was no dehiscence of uterine scar. It is concluded that with well established requisites it is possible to resolve by delivery with a great degree of confidence, at least 50% of cases with previous section.
Subject(s)
Vaginal Birth after Cesarean/methods , Adult , Cesarean Section , Female , Humans , Obstetric Labor Complications/epidemiology , Obstetric Labor Complications/therapy , Pregnancy , Pregnancy Trimester, Third , Retrospective Studies , Trial of LaborABSTRACT
When delivery induction with an unfavorable cervix, is required, the traditional conduct has been to use oxitocin and more recently prostaglandins as gel. The purpose of this report is to communicate the experience of a prospective work with a group of 48 patients with amenorrhea from 16 to 42.5 weeks of gestation with an unfavorable cervix. The idea was to modify cervical features in order to facilitate delivery induction in patients with the following diagnosis: 1, Prolonged pregnancy in 32 patients. 2. Severe pre-eclampsia in seven. 3. High blood pressure in five. 4. Intrauterine growth retardation in four. All the patients were evaluated with a Bishop index of three or less. The procedure consisted of introduction of a No. 14 or 16 Foley catheter through the cervical canal, filling the balloon with 30 ml, and simultaneous application of intravenous oxitocin controlled with an infusion pump. Cervical maturation was seen in all the patients, time was from 2 to 24 hours. In all the cases Bishop's index was greater than five after the procedure. Delivery via was vaginal in 26 patients, and cesarean section in 22. There were no infectious complications, nor other type in women nor in newborns. It was concluded that despite criticism, this procedure has shown to be useful, dependable, to mature the cervix, its is available for all gyneco-obstetricians and easy to carry out.
Subject(s)
Cervix Uteri/drug effects , Labor, Induced/methods , Adolescent , Adult , Apgar Score , Birth Weight , Cesarean Section , Female , Humans , Infant, Newborn , Labor, Induced/instrumentation , Obstetric Labor Complications/therapy , Oxytocin/administration & dosage , Pregnancy , Pregnancy Trimester, Third , Time FactorsABSTRACT
Cuando se requiere la inducción del parto con una cervix desfavorable, lo tradicional ha sido utilizar la oxitocina endovenosa y más recientemente las prostaglandinas en su forma de gel. El propósito de este informe es comunicar la experiencia de un trabajo prospectivo en un grupo de 48 pacientes con amenorrea entre 36 y 42.5 semanas de gestación con un cérvix desfavorable. La finalidad fue modificar las características cervicales para facilitar la inducción del parto en pacientes que tenían los siguientes diagnósticos: 1. Embarazo prolongado en 32 pacientes. 2. Pre-eclampsia severa en siete. 3. Hipertensión arterial en cinco, y 4. Retardo en el crecimiento intrauterino en cuatro. A todas las pacientes se les evaluó con un índice de Bishop de tres o menos. El procedimiento consistió en la introducción de una sonda de Foley No. 14 o 16 a través del canal cervical, llenado el balón con 30 ml. y aplicación simultánea de oxitocina endovenosa controlado con una bomba de infusión. La maduración del cervix se observó en todas las pacientes, oscilando el tiempo necesario entre 2 y 24 horas. En todos los casos el índice de Bishop fue mayor de cinco después del procedimiento. La vía de nacimiento fue vaginal en 26 pacientes y en 22 por operación cesárea. No se observaron complicaciones infecciosas ni de otra naturaleza en madres ni en los recién nacidos. Se concluye que a pesar de las críticas, este procedimiento ha mostrado ser útil, confiable, para madurar el cervix, al alcance de cualquier Gineco-Obstetra y fácil de realizar
