Showing 18 results for Catheter
Sadeghi S A, Soleimani A A,
Volume 62, Issue 3 (6-2004)
Abstract
Background: Epidural injection of the drugs such as opioids has rather been a successful method in controlling post operative pain.
Materials and Methods: In a clinical trial study, 50 Female patients, in a range of 20-40 years old and ASA class I, who were scheduled for gynecologic operation were investigated. They were randomly divided in two groups. Before induction of general anesthesia, an epidural catheter was placed for each patient. Sixty minutes after the end of operation, a 15-ml solution containing 50-microgram clonidine was injected through the epidural catheter in the first group. In the second group, a similar volume solution containing 50- microgram fentanyl was injected. The catheter was removed after all the patients were followed for 4 hours and their pain was assessed by VAS (Visual Analogue Scale) method.
Results: Our findings revealed that the clonidine group had more intense pain however they had fewer complications than the opioid group.
Conclusion: We concluded that although clonidine might act as an analgesic drug, but epidural injection of a single dose of 50 microgram of the drug could not be effective enough for postoperative analgesia.
Amir Keshvari, Mahboob Lesan Pezeshki, Masoud Younesian,
Volume 64, Issue 6 (8-2006)
Abstract
Background: The aim of this study was to evaluate the mechanical and infectious complications of continuous ambulatory peritoneal dialysis catheter in surgical wards of Imam Khomeini Hospital.
Methods: We retrospectively reviewed 80 catheters that were inserted into 69 patients (52 men and 28 women) with end-stage chronic renal failure during a period of 84 months (13 Nov. 1996 to 13 Nov. 2003.
Results: The mean age of patients was 48:35 years (16 to 79 years). The most common complications were infectious ones (71.25%), while the most common causes of the catheter removal were mechanical ones (46.5% vs. 39.55%. The predominate cause of the mechanical complications was improper position (17.5%). Migration of catheter to upper abdomen and outflow failure were the other common mechanical complications. The most common infectious complication was peritonitis (62.5%).
Conclusions: The occurrence of the mechanical complications is lower than the infectious ones, but the probability of catheter loss is higher if it occurs.
Arbabi Sh, Ashjaei B, Mamishi S,
Volume 65, Issue 14 (3-2008)
Abstract
Background: There are many methods for removal of tracheobronchial foreign bodies
but there are many situations where removal of a foreign body seems impossible and
may require a major surgical procedure. Familiarity with each method improves
physician decision making.
Case: A 17 months old baby with a history of foreign body aspiration suffered from long
term pneumonia. There was a round shape foreign body in bronchoscopic view that
could not be removed with standard methods, but was removed by application of Fogarty
catheter
Conclusion: Removal of round, spherical foreign bodies may be performed by Fogarty
Catheter preventing surgical intervention.
Ashegh H, Rezaii J, Esfandiari K, Roueentan A, Abouzari M,
Volume 66, Issue 3 (6-2008)
Abstract
Background: Laparoscopic techniques for the placement of peritoneal dialysis catheters are becoming increasingly popular. Recently, with the improvements in laparoscopic surgery, various methods for the insertion of peritoneal dialysis catheters have been reported, indicating that the laparoscopic insertion is preferred over the open and percutaneous techniques. The aim of this study was to introduce and assess a simplified laparoscopic method for the insertion of peritoneal dialysis catheters in continuous ambulatory peritoneal dialysis (CAPD) patients.
Methods: We enrolled 79 consecutive end-stage renal patients (46 men and 33 women) with a mean age of 50 years (range: 19-83 years) in this study. During the surgery, a 5-mm trocar was placed in the left upper quadrant for the optics and another 5-mm trocar was placed to the left of the umbilicus. Using the second trocar, a tunnel was formed 2 cm left of the umbilical plane for the insertion of a Tenckhoff catheter. Under direct vision, the catheter was advanced into the abdomen. The catheter was tested for patency. Catheters of all subjects were capped for two weeks before dialysis initiation.
Results: The mean duration of the operation was 15 minutes. Ten patients died during the follow-up period, all due to other medical problems, and six patients underwent renal transplantation however, no deaths or complications were observed during surgery. Early onset complications were seen in 12 patients (15.1%). The most frequent late-onset medical and mechanical complications were peritonitis (6.3%) and hernia (3.7%). During a follow-up period of four years, removal of the catheter was required in two patients as a result of peritonitis.
Conclusion: We obtained a low complication rate and a high catheter survival rate with this laparoscopic insertion of the Tenckhoff catheter. We believe future experience will encourage the use of this safe, simple and quick procedure.
Keshvari A, Jafari- Javid M, Najafi I, Chaman R, Nouri Taromloo Mk,
Volume 66, Issue 7 (10-2008)
Abstract
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Background: Chronic peritoneal dialysis
is a safe method for the treatment of end-stage renal failure. Worldwide,
patients on chronic peritoneal dialysis constititute approximately 15%
of the total number of patients on dialysis. In Iran, very few people have access
to chronic peritoneal dialysis, which is targeted by the Ministry of Health. This
lack of access is primarily due to the high occurrence of mechanical
complications. Improving catheterization procedures is an important way to
extend the use of peritoneal dialysis in Iran. Thus, a prospective study was
implemented to evaluate the outcome of a new laparoscopic technique for the insertion
of peritoneal dialysis catheters under local anesthesia.
Methods: A
total of 115 catheters (two-cuff, swan-necked, coiled) were
inserted into the peritoneal cavity of 109
patients with end-stage chronic renal failure during a 16-month
period. The method of insertion was a two-port laparoscopic technique with
local anesthesia and sedation. All patients were followed for 12
to 28 months. We prospectively evaluated mechanical
and infectious complications and survival rates of the catheters.
Results: The
average age of the patients was 51.5 years (range: 15-84
years) 54.8% of these patients were female. The overall
one-year and two-year catheter survival rates using this approach were 88%
and 73%, respectively. Event-free catheter survival
was 35%. The most common infectious and mechanical
complications were peritonitis in 52
cases (45.2%) and temporary dialysate leakage in 10
cases (8.7%) respectively.
Conclusion: Laparoscopic insertion of
peritoneal dialysis catheter with local anesthesia is a safe and simple
procedure, giving reasonable rates of catheter survival and complications.
Jalal Rezaei, Khalil Esfandiari, Hassan Tavakoli , Mahmood Sadooghi , Mehrdad Hasibi , Mehrdad Behzadi ,
Volume 67, Issue 6 (9-2009)
Abstract
Background: Central venous catheter (CVC) related infections are important complications of cathter application. This study assessed the usefulness of mupirocin in prevention and control of these infections.
Methods: In this randomized clinical trial, consecutive surgical patients requiring central venous catheter (for more than 2 days) in Amir-Alam Hospital from 2006-2008 were enrolled. Patients were divided in two groups in “case group” patients received topical mupirocin 2% every 48 hours at the time of insertion of catheter and dressing change and for “control group” mupirocin was not used. All of the patients received chlorhexidine and enoxoparin as complementary treatments. Two groups were comparable in regard of age, sex and risk factors.
Results: One hundred eighteen patients enrolled in the study (57 in case and 61 in control group) completed the study. 84 catheters in case group and 88 catheters in control group were inserted. The catheters in 90% of patients were inserted in jugular vein. At the end of study 29(16.8%) patients (16 in control versus 13 in case group) had catheter colonization (p=NS). Catheter related bloodstream infection was observed in 16(9.3%) patients (6 in case versus 10 in control group) (p=NS).Catheter related local infection was seen in 2(1.1%) patients of control versus none of mupirocin group. (p=NS).
Conclusions: Mupirocin was not effective to control and prevention of bacterial colonization and catheter related infection.
Mohammadi M, Barkhordari Kh, Khajavi Mr,
Volume 68, Issue 4 (7-2010)
Abstract
Background: Epidural catheters are seldom difficult to remove from patients. The breakage of the catheters is uncommon, troublesome and occasionally dangerous.
Case presentation: A lumbar epidural catheter inserted in a 17 year-old man for applying anesthesia for internal fixation of femur fracture and subsequent postoperativeepidural analgesia. In the third postoperative day, during unsuccessful attempt for removing the catheter, it was broken and was retained in his back. A CT- scan was performed and shows a fragment of catheter in the sub- laminar ligament between L3 and L4 without any connection with epidural space. As the patient had no complaint the fractured fragment was left in site and he was just followed up in the clinic.
Conclusion: The knowledge of practical method in locating the retained epidural catheter, and the indication for surgical removal are very important. CT- scan is useful in showing the mechanism and locating the epidural catheter entrapment and facilitating surgical follow-up.
Bagheri R, Nurshafiee S,
Volume 68, Issue 5 (8-2010)
Abstract
Background: Central venous catheters are useful instruments in monitoring of critical patients and are important roots for total parentral nutrition. The catheters are widely used in general wards and intensive care units. Their use may be associated with serious and rare complications.
Case presentation: We reported a 24 years old woman that admitted to Ghaem hospital Mashhad University of Medical Science, in Mashhad, Iran, because of penetrating chest wall injury and surgical exploration indicated due to massive hemorrhage. Central vein (right jugular vein) was canulated for resuscitation and monitoring. Superior vena cava was injured after canulation and presented with delay massive mediastinal hematoma.
Conclusion: We aim to introduce this rare complication and its management. This management could be conservative or surgical intervention according to severity of the vein damage.
Farsavian Aa, Emkanjou Z, Shirali A,
Volume 69, Issue 8 (11-2011)
Abstract
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Background: Distinguishing the origin of ventricular tachycardia (VT) by electrocardiogram (ECG) which is performed in all
patients, helps to diagnose the cause of VT before trying invasive procedures. The aim of this study was to
compare the ECG findings in patients with VT originating from Right or Left Ventricular Outflow Tracts (RVOT or LVOT).
Methods : Fifty nine patients with VT originating from LVOT or RVOT were selected for this cross-sectional study. The patients were
recruited while they were attending Shahid Rajaei Hospital in Tehran, Iran in 2009-2010 for catheter ablation.
The participants were evaluated for the prevalence of LVOT and RVOT and were compared for the success
rate of radiofrequency catheter ablation.
Results : Out of 59 patients, 44.1% were male and 55.9% were female. The mean age of the participants was 41.67 (SD=13.76) years. QRS transition and notch in ECGs were significantly different
(respectively, P=0.027 and P=0.007) between patients with LVOT and RVOT. R-to-QRS duration in precordial leads was significantly longer in patients
with LVOT than
those with RVOT [0.81 (SD=0.06) ms vs. 0.69 (SD=0.16), P=0.015]. Successful ablation was performed in 73.2% of patients with RVOT versus 93.3% of those with LVOT, but despite a higher rate the
differences were not statistically significant (P=0.215).
Conclusion: In this study, RF catheter ablation was
successful like other studies on patients with ventricular tachycardia and RVOT VT and LVOT VT had significant differences
in notch, QRS transition and R-to-QRS duration in precordial leads which are important in differentiating
between the two conditions.
Ghane Mohammad-Reza , Saburi Mohammad-Reza , Saburi Amin ,
Volume 69, Issue 12 (3-2012)
Abstract
Background: Pneumothorax is a potential life-threatening condition especially in patients with underlying disorders. In this study we compared the diagnostic accuracy of general practitioners and emergency medicine specialists in interpreting chest x-rays (CXR) suspected of having iatrogenic pneumothorax in emergency departments.
Methods: This cross-sectional study was conducted in Shahid Chamran Hospital in Tehran, Iran during 2008- 2010. The study was designed to compare the ability of general practitioners and emergency medicine specialists in diagnosing iatrogenic pneumothorax regarding 500 CXRs of one-hundred patients admitted for upper central venous catheterization.
Results: General practitioners and emergency medicine specialists could accurately (P<0.001) diagnose pneumothorax in 484 (96.8%) and 497 (99.4%) CXRs, respectively. None of the underlying causes of the condition affected the diagnostic accuracy of both physician groups (P>0.05).
Conclusion: These findings indicate that the diagnostic accuracy of emergency medicine specialists is significantly higher than those of general physicians. The diagnostic accuracy of both physician groups was higher than the values in similar studies that signifies the role of relevant training given in the emergency departments of the Hospital.
Alemohammad M,
Volume 70, Issue 11 (2-2013)
Abstract
Insertion of central venous catheter is an accepted method for hemodynamic monitor-ring, drug and fluid administration, intravenous access, hemodialysis and applying cardiac pace-maker in hospitalized patients. This procedure can be associated with severe complications. The aim of this article is to provide a practical approach to prevent catheter malposition in states that the guide wire will not pass freely.
During central venous insertion in internal jugular vein using modified seldinger technique, when after venous insertion, the passage of the guide wire shows difficulties and don’t pass freely, insertion of an intravenous cannula over the wire and re-insertion of the wire can help to prevent malposition of the wire and the catheter. Use of an intravenous cannula over the guide, in situations that the guide wire cannot pass freely among the needle inserted in internal jugular vein, and re-insertion of the guide can probably prevent or reduce the tissue or vascular trauma and the associated complica-tions. This simple maneuver can be helpful in difficult cases especially in cardiac surgery patients who receive high dose heparin and it is necessary to avoid traumatize-tion of carotid artery.
Mahvash Zargar , Mohammad Ali Nazari , Leila Hormozy , Hasti Madovi Mohammadi,
Volume 72, Issue 3 (6-2014)
Abstract
Background: Any time before labor that termination of pregnancy for mother and fe-tus is better than keeping pregnancy, this is indication of induction for labor. The condi-tion of cervix is the most important factor for labor induction. Cervical condition, In many cases that candidate for induction of labor before labor pain, is poor. As the cervical ripening is quite important for success of labor induction. This study is attempting to compare two methods of cervical ripening.
Methods: During this clinical study, 100 patients admitted in Ahwaz Imam Khomeini Hospital from 2010 to 2011. All of these patients had BISHOP score bellow 5, were di-vided to two groups for cervical ripening. Group one: trans cervical catheter and group two: laminaria. After placing transcervical foley catheter and laminaria for patient in-duction with oxytocin was started according to classic protocol. Then the time lapse from the beginning of induction to enter the active phase of labor and also from start of induction till delivery and appearing the side effect in both group was assessed. The result was analysed by SPSS 16 program.
Results: Fifty three of patient (53%) were primiparous and the rest 47 (47%) were mul-tiparous. All of them had bishop score bellow 5. The average age for the patient group 1 was 27.1 and the average age for other group was 27.18. The time lapse from start of induction to enter active phase of labor in first group was 5.7±2.67 hours and this time for 2nd group was 7.51±2.33 hours. Also the time interval between the start of induction and delivery in group 1 was 10.3±4.35 hours and this time for group 2 was 12.5±4.9 hours. In both cases there was meaningful difference between two groups. There was no difference between both group for appearing the side effects.
Conclusion: Based on this study, it seems using trans- cervical catheter for cervical rip-ening and aid to successful induction of labor is beneficial.
Mojtaba Hedayat Yaghoobi , Mohammadmahdi Sabahi , Elahe Ghaderi , Mohammad Ali Seifrabiei , Farshid Rahimi Bashar ,
Volume 77, Issue 11 (2-2020)
Abstract
Background: Health care associated infections (HAIs) are a class of infections that infect patients during hospital admissions and receive medical services. These infections occurs within 48 to 72 hours of admission and up to 6 weeks after discharge. Surveillance of device-associated infections (DAIs) in intensive care units (ICUs) is substantial in planning healthcare strategies. This study was conducted to determine the device-associated infections' burden and antimicrobial resistance patterns.
Methods: In this descriptive-analytic study, three common device-associated infections included central line-associated bloodstream infection (CLA-BSI), ventilator associated pneumonia (VAP), and catheter-associated urinary tract infection (CA-UTI), were assessed in intensive care units of Besat Hospital in Hamedan from April 2017 to April 2018. In order to determine the incidence of device-associated infections, the number of device-associated infection cases was calculated during the study period and divided into the number of device-days used. The device-days included all days of exposure to that device (vascular catheter, endotracheal tube (ventilator), or urinary catheter) in all patients in the study population.
Results: Out of 1806 intensive care unit admitted cases, 168 patients (9.3%) were device-associated infection with distribution of 92 cases (55%) of ventilator-associated pneumonia (VAP), 56 cases (34%) of catheter-associated urinary tract infection (CA-UTI) and 20 cases (11%) of central line-associated bloodstream infection (CL-BSI). The incidence of VAP, CA-UTI and CL-BSI was 44.7, 17.5, and 21.61 days, respectively. The most organisms were Acinetobacter (27.4%), Klebsiella (18.3%), Escherichia coli (E. coli) (15.4%). Vancomycin-resistant enterococcus (VRE) was 75%. Acinetobacter resistance to colistin and carbapenem was 16.8%. About half of Pseudomonas isolates were resistant to meropenem.
Conclusion: According to the present findings of this study, a high incidence of device-associated infections and resistant organisms in our intensive care units were documented, which represents a need to reinforce the preventive and control programs. Various results in different studies can be due to differences in the level of health care in different centers and countries.
Roghieh Golsha, Aref Gooran Orimi , Behnaz Khodabakhshi, Fatemeh Mehravar,
Volume 78, Issue 4 (7-2020)
Abstract
Background: The mortality rate of sepsis and pneumonia is higher in end-stage renal disease (ESRD) patients than in the general population. Bacterial infections are the most common cause of hospitalization in dialysis patients and the most common source of bacteremia is vascular access in these patients. The aim of this study was to determine the prevalence of infectious causes of hospitalization in patients with end-stage renal failure in Gorgan.
Methods: This cross-sectional study was performed on patients with ESRD who were admitted to the 5 Azar Medical Education Center of Gorgan City during 2014 to 2016. Patients' information was collected through their clinical records and analyzed statistically.
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Results: The prevalence of infectious diseases in ESRD patients during the 3 years was 12.7%, out of 100 hospitalized patients with ESRD and infectious causes, the most common type of infectious disease was catheter infection (43%) and sepsis (18%), urinary tract infection (11%) and pneumonia (8%) were the next. The most common infectious causes leading to hospitalization in men with the ESRD were catheter infection, sepsis, and pneumonia, respectively, and in women, catheter infection, sepsis, and urinary tract infection. The highest incidence of catheter infection was in the age group of 66-70 years (30.2%), 71-75 (25.6%), and above 71 years (25.6%), respectively. The highest incidence of sepsis occurred in the age group of 75-71 years (38.9%) and also the highest incidence of urinary tract infections in the age group of less than 65 years. Age (P=0.003), sex (P=0.01), duration of disease (P=0.009), addiction (P=0.01), and diabetes (P=0.01) were the most common risk factors for infectious diseases in patients with ESRD.
Conclusion: The results of this study showed that catheter infection is the most common cause of infection in patients with end-stage renal disease (ESRD). Therefore, avoiding multiple vascular manipulations, disinfection of the catheter, timely replacement, and training of dialysis staff are effective in reducing catheter infections.
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Neda Pak , Fateme Zamani, Sara Naybandi Atashi, Anese Saleh Nia,
Volume 78, Issue 6 (9-2020)
Abstract
Background: Central venous catheterization is a procedure that is being performed frequently especially in critical clinical settings. In such conditions, good knowledge of the surface anatomy of venous structures is vital to avoid possible complications which could result in life-threatening situations such as bleeding and pneumothorax. Considering the difference between venous anatomy of children and adults and even among different age groups of children, and the fact that our recent knowledge of anatomy is based on studies performed on non-Iranian population, we decided to evaluate the anatomy of the intrathoracic systemic venous system in adults and children and assess the rate of catheter malposition in children.
Methods: This was a retrospective cross-sectional study performed in Dr. Shariati Hospital and Children Medical Center of Excellence, Tehran, Iran, from April 2016 to August 2019. In our study, the surface location of brachiocephalic vein (BCV) formation, the junction of superior vena cava (SVC) to right atrium and, formation of SVC were examined in 150 contrast-enhanced chest computed tomography (CT) scans in children. They were classified into three groups based on their age (neonates to three years, three to seven years, and seven to ten years). Also, 100 similar CT scans in adults were being studied. The other category which has been evaluated through 130 pediatric X-rays, was the location of the tip of the central venous catheter.
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Results: The formation of BCV was mostly depicted posterior to the sternoclavicular joint in adults while in children it’s located posterior to the medial aspect of the head of clavicle. In adults, the SVC formation was at first intercostal space (ICS) in 52% and second ICS in 29%. In first group of children, SVC was commonly at the level of 2nd costal cartilage (CC), but changed to the first ICS or first CC by increasing age. In adults, junction of right atrium to SVC was at the 3rd CC then 4th CC but in the first group of children was located at the 4th CC that changed to 3rd ICS /3rd CC by increasing age. Also, the tip of central venous catheters was located in the proper position in 74.7% of cases.
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Conclusion: This study indicated the different anatomy of central veins in children and adults which could be a cause for malposed central catheter, so knowing this difference and controlling the tip of the catheter by ultrasound during catheterization could help in avoiding this malpositioning.
Mohamadreza Arabi, Simin Najafgholian , Morteza Gharibi, Fateme Rafiaee, Mehran Azami , Mojtaba Ahmadlou,
Volume 79, Issue 6 (9-2021)
Abstract
Background: Acute compartment syndrome is considered a debilitating complication of limb trauma. Early detection of this compartment syndrome helps us in the early initiation of treatment which will result in preventing its subsequent complications reported in these cases.
Methods: This research was an analytical cross-sectional study. Patients with direct trauma to extremities, who were referred to the emergency department of Valiasr and Amir Al-Momenin hospitals were studied from October 2018 to April 2019 in Arak, Iran. Patients were selected if they met all of the inclusion criteria and none of the exclusion criteria. Vital signs were measured and recorded for each patient. Also, the results of physical examination, intra-compartmental pressure measurement by a wick catheter and the level of the creatine phosphokinase were recorded. All data analyses were performed with the use of SPSS v21 software.
Results: A total number of 70 subjects were included in this study, comprising 65 males (93.1%) and 5 females (6.9%). The results showed that there is a significant relationship between intra-compartment pressure and the level of creatine phosphokinase enzyme. The higher the intracompartmental pressure, the higher the creatine phosphokinase level. Statistically significant associations were observed between intracompartmental pressure and pallor, edema, lack of limb pulse, and diastolic blood pressure. No significant relationship was found between intracompartmental pressure and limb pain, numbness, inability to move the injured limbs, and systolic blood pressure. In addition, our findings indicated that creatine phosphokinase is significantly associated with edema and lack of limb pulse. No significant relationship was found between creatine phosphokinase with pain, pallor, numbness, inability to move limbs, and systolic and diastolic blood pressure.
Conclusion: The study findings suggest that measurement of intracompartmental pressure could be considered as an effective alternative approach to creatine phosphokinase levels to diagnose compartment syndrome. So, this will prevent irreparable damage to the extremities and is of great importance.
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Kowsar Sadat Ashrafi, Nasser Saeedi, Parvin Soltani, Ali Sadough Abbasian , Mohammad Rafiei, Fereshteh Nejati, Mahdieh Gholamzadeh, Mojtaba Ahmadlou,
Volume 80, Issue 12 (3-2023)
Abstract
Background: Adequacy of dialysis is a very important issue in dialysis patients, so comparing the adequacy of dialysis in different dialysis methods is very important. Therefore, due to the fact that the number of people undergoing dialysis through fistulas and catheters varies in different centers, and depending on different centers, there is a possibility of decreasing or increasing the adequacy of dialysis, so we decided to do this comparison in Arak support center.
Methods: In this analytical-cross-sectional study, the dialysis patients of Hami Arak Center from April 2019 to September 2019 were divided into two groups (the first group with permanent catheter, the second group with arteriovenous fistula) based on vascular access. The both groups were matched in terms of age, sex, weight, pump speed, filter size and also the duration of dialysis. All patients were dialyzed with the same type of dialysis machine, and the duration of hemodialysis for all samples was 4 hours in each session. To confirm the reliability of the device, it was calibrated before each use and the same setting was used for all samples. The blood samples were taken from the arterial route before dialysis and starting the dilution with heparin or normal saline. Statistical models of dialysis adequacy of patients in two groups were measured using the Kt/V criterion, SPSS and AMOS data analysis was performed.
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Results: In the analysis of covariance of BUN before dialysis, there is a statistically significant difference in the studied groups (P<0.05), also in the UF and URR variables, dialysis time and the number of times of dialysis in three consecutive repetitions, there is a statistically significant difference in the studied groups. (dime fistula and catheter) are not present (P<0.05).
Conclusion: In this study, during repeated repetitions, 22% of the dialysis adequacy in the two groups did not have good adequacy, and 78% of the patients in the two groups had appropriate dialysis adequacy.
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Masoume Mirteimouri, Seyyedeh Azam Poorhosseini , Maliheh Rakhshanifar, Seyede Houra Mousavi Vahed , Fedyeh Haghollahi,
Volume 81, Issue 3 (6-2023)
Abstract
Background: The success of labor induction depends on the condition of the cervix at the time of delivery. This study examines the effect of labor induction with an intra-cervical Foley catheter and oxytocin compared to a Foley catheter and misoprostol on cervical preparation and delivery rate in the first 24 hours after induction.
Methods: In a randomized clinical study, pregnant women with a singleton pregnancy and a gestational age of more than 40 weeks, with a Bishop score less than 4 and an intact amniotic sac referred to Umm al-Binin Hospital in Mashhad from 2017 to 2018 were included in the study. They were randomly divided into two groups of Foley catheter and oxytocin (1) or Foley catheter and misoprostol (2). In the first group, immediately after placing the Foley catheter; Oxytocin was started with a dose of 2 milliunits per minute, and every 20 minutes, 2 milliunits were added to reach the maximum dose of 30 milliunits per minute (induction method with a low dose). In the second group, after Foley catheter insertion, sublingual misoprostol was prescribed at a dose of 25 micrograms every 4 hours up to a maximum of 6 doses.
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Results: 74 pregnant women were randomly evaluated in two groups of 37 people. There is no statistically significant difference in the demographic variables in the two groups. There was a significant difference in the labor rate in the first 24 hours, and it was higher in the oxytocin group (P=0.009). Bishop's score after 24 hours of induction was not significantly different in the two groups. Reaching the active phase was significantly shorter in the oxytocin group. (P=0.01). The time of catheter removal in both groups and the rate of cesarean section and the occurrence of complications were the same in both groups.
Conclusion: The use of oxytocin with a Foley catheter inside the cervix can accelerate the preparation of the cervix and increase the chance of labor in the first 24 hours, but it does not affect labor complications.
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