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  • Title: Induction of abortion by condom-Foley catheter method in pregnant women with intra-uterine foetal death.
    Author: Mekbib TA.
    Journal: Ethiop Med J; 1994 Apr; 32(2):107-13. PubMed ID: 8033876.
    Abstract:
    To induce abortion in women with intra-uterine foetal death (IUFD), during a two-year period (August 1990 to October 1992), at Yekatit 12 Hospital, Addis Abeba, Ethiopia, condom-Foley catheter method (CFCM) with oxytocin, and oxytocin infusion alone were compared. All 25 pregnant women randomly assigned to the CFCM aborted within 24 hr, a 100% success rate with an induction-abortion time interval of 14.6 hr (p < 0.001), whereas among 20 patients who were treated with oxytocin infusion alone, induction failed in all. Repeated induction in the second group resulted in a marked delay of abortion; these patients were crossed over to either combined medical and surgical induction or to the CFCM depending on their cervical status. The rapid cervical dilatation and safe abortion in pregnant women with IUFD make the CFCM a superior procedure to induction of abortion with oxytocin infusion alone. In places where there is no experience with the use of prostaglandins and the agent, which may have undesirable side-effects, is unavailable, the CFCM is a simple cost-effective technique which could be used safely. In the Department of Obstetrics and Gynecology, Yekatit 12 Hospital, Addis Ababa, Ethiopia, during August 1990-October 1992, pregnant women at 20-28 weeks of gestation who presented with intra-uterine fetal death (IUFD) were enrolled in a comparative study after giving verbal consent. Patients were randomly assigned to two groups. In the first group, abortion was induced in the conventional method by oxytocin infusion alone. In the second group, in addition to oxytocin infusion, the condom-Foley catheter method (CFCM) was employed. All 25 patients with the CFCM aborted within 24 hours, yielding an induction abortion time interval (IATI) of 14.60 +or- 5.27 hours. In contrast, induction failed twice among the 20 patients getting oxytocin infusion alone, and 5 patients were submitted to combined medical and surgical induction (CMSI) (IATI of 59.4 +or- 8.7 hours), as they had an appropriate cervix, and they expelled the fetus within 48 hours. Among the remaining 15 patients induction failure occurred for the third time, and 8 of them had developed an appropriate cervix (Bishop scone = 4-6), but the other 7 patients did not show any cervical change. Those with the appropriate cervix were submitted to CMSI, and those whose cervical state was unchanged were transferred to the CFCM. Both groups aborted within 72 hours; the respective IATIs were 93.5 +or- 12.0 hours and 86.7 +or- 4.8 hours. In 48.9% of the patients, the cause of the IUFD was preeclampsia/eclampsia (2 patients had eclampsia). One patient was positive for syphilis and another was diabetic, both received treatment before admission. There was no abnormal bleeding or any signs of infection. Blunt curettage was performed in 37.8% of patients between 20 and 26 weeks of gestation after the expulsion of the fetus in the oxytocin group. 53.3% of the patients in the CFCM group also received this treatment.
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