title: Labor induction by transcervical balloon catheter and cerebral palsy associated with umbilical cord prolapse.
abstract: OBJECTIVE
  The aim of this study was to determine whether the use of transcervical balloon catheter (TCBC) for induction of labor (IOL) is a risk factor for cerebral palsy (CP) associated with umbilical cord prolapse (UCP-CP) in singleton pregnancies with cephalic presentation.
  
  
  METHODS
  Among all 102 infants with CP who were preliminarily determined as caused by antenatal and/or intrapartum hypoxemia by the Japan Council for Quality Health Care until April 2012, all 56 infants who met all of the following criteria were studied: cephalic singleton pregnancy, reassuring fetal status on electronic cardiotocogram at time of admission to obstetric facilities for labor pains, ruptured fetal membranes, and/or IOL, and hypoxic-ischemic encephalopathy at birth. Clinical backgrounds were compared between six infants with UCP-CP and the remaining 50 infants with CP not associated with UCP (non-UCP-CP).
  
  
  RESULTS
  Frequencies of IOL (83% [5/6] vs 32% [16/50], P = 0.0236), use of TCBC (67% [4/6] vs 10% [5/50], P = 0.0044), and amniotomy (67% [4/6] vs 24% [12/50], P = 0.0494) were significantly higher in the UCP-CP than the non-UCP-CP group. Only TCBC was a risk factor significantly associated with UCP-CP after logistic regression analysis, yielding an odds ratio of 18.0 (95% confidence interval, 2.6-124; P = 0.003). Saline volumes of 80-150 mL were used for TCBC inflation in the four UCP-CP patients.
  
  
  CONCLUSIONS
  Use of TCBC with a saline volume ≥ 80 mL was a significant risk factor for UCP-CP; however, the absolute risk of UCP-CP was estimated to be very low, approximately one in 7875 TCBC users.
authors.affiliation: Department of Obstetrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan. taka0197@med.hokudai.ac.jp
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yamada
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Cho
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamada
authors.forename: Mamoru
authors.initials: M
authors.lastname: Morikawa
authors.forename: Hisanori
authors.initials: H
authors.lastname: Minakami
mesh_terms: D057785:Catheters / Q000009:adverse effects; D002547:Cerebral Palsy / Q000151:congenital*; D005260:Female; D005315:Fetal Diseases / Q000209:etiology*; D006801:Humans; D007231:Infant, Newborn; D007751:Labor, Induced / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D011247:Pregnancy; D011391:Prolapse; D012189:Retrospective Studies; D014470:Umbilical Cord