Sezaryen Sonrası Vajinal Doğumda Balon Kateter Uygulaması: Sistematik Derleme

Öz

Amaç: Sezaryen sonrası vajinal doğumda mekanik dilatasyon amacıyla balon kateter kullanımına yönelik 2011-2021 tarihleri arasında yayınlanmış randomize kontrollü retrospektif ve prospektif deneysel çalışmaları gözden geçirmek ve elde edilen verileri sistematik biçimde incelemektir. Gereç-Yöntem: Konu ile ilgili ‘’Pubmed’’ veri tabanı kullanılarak 116 çalışmaya ulaşıldı. Çalışmaların tümü gözden geçirilerek dahil edilme kriterlerini karşılayan 10 yayın çalışma kapsamına alındı. Ulaşılan çalışmalar, yöntemleri ve bulguları açısından sistematize edildi. Bulgular: Çalışmalar incelendiğinde sezaryen sonrası vajinal doğumda mekanik dilatasyon amacıyla yoğunlukla tek balonlu kateter uygulandığı ve sıvı volümünün ortalama 30-50 ml olduğu görülmüştür. Foley balon kateter kullanımı ile ilk 24 saatte servikal Bishop Skoru’nda artış olduğu ve vajinal doğum oranının %57, sezaryen doğum oranının %43 olduğu belirlenmiştir. Servikal olgunlaşma sağlandıktan sonra eylemin devamlılığı için düşük doz oksitosin desteğine ihtiyaç olabileceği belirtilmiştir. Medikal indüksiyona kıyasla artmış maternal ve fetal komplikasyon görülmemektedir. Sonuç: Sezaryen sonrası vajinal doğum indüksiyonunda foley-balon kateter kullanımı güvenli ve etkili bir yöntemdir. Artış eğiliminde olan sezaryen oranlarını azaltmak için foley-balon kateter kullanımının yaygınlaştırılması konusunda klinisyenler teşvik edilmelidir. Kateter seçimi için serviks mutlaka değerlendirilmelidir. Anahtar Sözcükler: Sezaryen sonrası vajinal doğum, önceki sezaryen, balon kateter, foley, servikal olgunlaşma.

Anahtar Kelimeler

• Sezaryen sonrası vajinal doğum
• önceki sezaryen
• balon kateter
• foley
• servikal olgunlaşma.

A Systematic Review in Balloon Catheter Application in Vaginal Birth After Cesarean

Öz

Aim: To investigate and review retrospective and prospective randomized controlled trials about balloon catheter application for mechanical dilatation in vaginal birth after caesarian in studies published between 2011-2021 and to systematically examine the data. Instrument and Methods: Pubmed database was used and 116 randomized controlled trials were reached. All of the studies were examined and 10 studies that met the inclusion criteria were included in the review. The studies that were reached were systematised in regards to their methods and findings. Findings: When the studies were examined, it was seen that a single-balloon catheter was mostly used for mechanical dilation in vaginal delivery after cesarean section and the balloon fluid volume was 30-50 ml on average. It was determined that there was an increase in the cervical Bishop Score in the first 24 hours with the use of foley balloon catheter, and the vaginal delivery rate was 57% and the cesarean delivery rate was 43%. It has been stated that low-dose oxytocin support may be needed for the continuation of the action after cervical ripening was achieved. Compared to medical induction, no increased maternal and fetal complications were reported. Conclusion: Foley-balloon catheter is a safe and effective method for induction of vaginal birth after cesarean section. Clinicians should be encouraged to expand the use of foley-balloon catheters to reduce the inreasing rate of caesarean delivery. Cervix must be evaluated in the choice of catheter types. Key words: Vaginal birth after cesarean, previous cesarean, balloon catheter, foley, cervical ripening.

Anahtar Kelimeler

• Vaginal birth after cesarean
• previous cesarean
• balloon catheter
• foley
• cervical ripening.

Kaynakça

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