title: Case series of labor induction in twin gestations with an Intrauterine Balloon catheter.
abstract: The efficacy and safety of labor induction using an intrauterine balloon catheter in twin pregnancies has been evaluated. During the study period (1992-1997), labor was induced at 36-42 weeks in 17 twin gestations. Labor induction was indicated for preeclampsia (n = 10), birth weight discordance (n = 3), suspected fetal distress (n = 2) and postdates (n = 2). Twin A was in vertex presentation in all cases. An intrauterine balloon catheter was inserted transcervically followed by augmentation whenever required. Vaginal delivery was achieved in 15 (88.2%) patients. The mean interval from balloon insertion to delivery was 17.05 h, with 80% deliveries occurring within 24 h of catheter insertion and 80% occurring within 12 h of catheter expulsion. Birth weight was 2,514+/-244 and 2,421+/-367 g for twin A and B, respectively. Oxytocin was required in 4 patients. Postpartum hemorrhage was noted in 1 patient. One patient with no progress of labor and 1 with suspected intrapartum fetal distress required cesarean section. All neonates had a 5-min Apgar score of 10. The data suggest that an intrauterine balloon catheter appears to be safe and effective to induce labor in twin gestations.
authors.affiliation: Department of Obstetrics and Gynecology, Kaplan Medical Center, Rehovot, Israel. manorm@md2.huji.ac.il
authors.forename: M
authors.initials: M
authors.lastname: Manor
authors.forename: I
authors.initials: I
authors.lastname: Blickstein
authors.forename: A
authors.initials: A
authors.lastname: Ben-Arie
authors.forename: A
authors.initials: A
authors.lastname: Weissman
authors.forename: Z
authors.initials: Z
authors.lastname: Hagay
mesh_terms: D000328:Adult; D001724:Birth Weight; D002404:Catheterization; D005260:Female; D005316:Fetal Distress; D005865:Gestational Age; D006801:Humans; D007746:Labor Presentation; D007751:Labor, Induced / Q000379:methods*; D011225:Pre-Eclampsia; D011247:Pregnancy; D011272:Pregnancy, Multiple; D011446:Prospective Studies; D013997:Time Factors; D014427:Twins; D014599:Uterus