Management of Foley catheter induction among nulliparous women: a retrospective study

BMC Pregnancy and Childbirth

Leena Rahkonen¹  Jorma Paavonen¹  Irmeli Nupponen²  Ansa Aitokallio-Tallberg¹  Veli-Matti Ulander¹  Oskari Heikinheimo¹  Heidi Kruit¹ 

[1] Department of Obstetrics and Gynecology, University of Helsinki, Helsinki University Hospital, Haartmaninkatu 2, Helsinki 00029 HUS, Finland;Children’s Hospital, University of Helsinki, Helsinki University Hospital, Helsinki, Finland

关键词: Neonatal infection;    Maternal infection;    Nulliparous;    Caesarean delivery rate;    Foley catheter;    Induction of labour;   

Others  :  1232779
DOI  :  10.1186/s12884-015-0715-9

 received in 2015-03-26, accepted in 2015-10-22,  发布年份 2015

【 摘 要 】

Background

Induction of labour is associated with increased risk for caesarean delivery among nulliparous women. The aims of this study were to evaluate the risk factors for caesarean delivery and to investigate the risk of maternal and neonatal infections in nulliparous women undergoing induction of labour by Foley catheter.

Methods

This clinical retrospective study of 432 nulliparous women with singleton pregnancy and intact amniotic membranes at or beyond 37 gestational weeks scheduled for induction of labour by Foley catheter was conducted over the course of one year, between January 2012 and January 2013, in Helsinki University Hospital. The main outcome measures were caesarean section rate and maternal and neonatal infections. Univariate and multivariate logistic regressions were used to estimate relative risks by odds ratios with 95 % confidence intervals.

Results

The caesarean section rate was 39.1 % (n = 169). In multivariate regression analysis, the factors associated with caesarean section were the need for oxytocin for labour induction [OR 2.9 (95 % CI 1.8-4.5) p < 0.001] and early epidural analgesia [OR 9.9 (95 % CI 2.1-47.5), p = 0.004]. The maternal intrapartum infection rate was 6.3 %, and the clinical neonatal infection rate was 2.8 %. In multivariate analysis, gestational diabetes was associated with maternal intrapartum infection [OR 4.3 (95 % CI 1.7-11.0, p = 0.002] and early epidural analgesia with neonatal clinical sepsis [OR 10.5 (95 % CI 1.4-76), p = 0.02].

Conclusions

Oxytocin induction and early epidural analgesia were associated with caesarean delivery. Gestational diabetes and early epidural analgesia were associated with infectious morbidity. Since the first caesarean delivery has a major impact on subsequent pregnancies, optimising labour induction among nulliparous women is important.

【 授权许可】

   
2015 Kruit et al.

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