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Souza A.S.R.,Federal University of Pernambuco | De Menezes Medeiros Junior W.,Curso Academico de Medicina | De Araujo B.B.T.F.,Curso Academico de Medicina | De Albuquerque Neiva Coelho I.C.C.,Institute Medicina Integral Professor Fernando Figueira IMIP | De Queiroz Lins Guerra G.V.,Institute Medicina Integral Professor Fernando Figueira IMIP
Revista Brasileira de Ginecologia e Obstetricia | Year: 2015

PURPOSE: To describe the maternal and fetal outcomes with the use of the Foley catheter for induction of labor in high-risk pregnant women with previous caesarean section. METHODS: An interventive and descriptive study was conducted from November 2013 to June 2014. A total of 39 pregnant women at term, with a live fetus, cephalic presentation, estimated fetal weight <4,000 g, with previous cesarean section, medical indications for induction of labor, Bishop score ≤6 and amniotic fluid index >5 cm were included. A number 16F Foley catheter was introduced for a maximum of 24 hours, and was considered to be satisfactory when the patient began labor within 24 hours. RESULTS: Labor was successfully induced in 79.5% of pregnant women. Nine women achieved vaginal delivery (23.1%), with a frequency of 18% of vaginal births occurring within 24 hours. The main indications for the induction of labor were hypertensive disorders (75%). The mean interval between the placement of the Foley catheter and the beginning of labor and delivery were 8.7±7.1 and 14.7±9.8 hours, respectively. Meconium-stained amniotic fluid was observed in two patients; and an Apgar score <7 in the first minute was detected in 5 newborns (12.8%). CONCLUSIONS: The Foley catheter is an alternative for the induction of labor in women with previous caesarean section, despite the low vaginal delivery rate.


Souza A.S.R.,Institute Medicina Integral Prof Fernando Figueira Imip | Souza A.S.R.,Federal University of Pernambuco | Andrade L.R.,Curso Academico de Medicina | Silva F.L.T.,Institute Medicina Integral Prof Fernando Figueira Imip | And 2 more authors.
Revista Brasileira de Ginecologia e Obstetricia | Year: 2013

Purpose: To determine maternal and perinatal outcomes in pregnant women with low amniotic fluid, according to the amniotic fluid index (AFI). Methods: A cohort study conducted on 176 patients admitted to the high risk ward of Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), in Recife, Pernambuco, Brazil. Amniotic fluid was measured by the amniotic fluid index, and classified as low when between 5.1 and 7.9 cm, moderate oligohydramnios between 3.1 and 5.0 cm, and severe oligohydramnios when less than or equal to 3.0 cm. To determine the difference between the three groups of categorical variables studied the chi-square and Fisher exact tests were used, when applicable, and for the numerical variables the Mann-Whitney test was applied, with the level of significance set at 5%. Results: Fetal malformation more frequently occurred when oligohydramnios was severe. Hypertensive disorders, however, were associated with moderate oligohydramnios. There was similarity between the three groups in relation to premature rupture of membranes and other causes. Low amniotic fluid was more frequently diagnosed when tested at the gestational age of 32 weeks or earlier. Regarding the perinatal outcomes, the incidence of Apgar score <7 in the 1st and 5th minutes, perinatal death, neonatal jaundice and pulmonary hypoplasia was higher when oligohydramnios was moderate to severe. Conclusions: Maternal and perinatal causes and outcomes in pregnant women with low amniotic fluid vary with respect to their AFI, severe oligohydramnios being associated with fetal malformation and other adverse perinatal outcomes.

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