Title : Cooks balloon IOL increases risk of cord prolapse
Abstract:
Objective: To identify whether induction of labour with Cooks Balloon increases risk of cord prolapse.
Design: Retrospective case notes analysis of patients who had CAT1 CS due to cord prolapse in a district general hospital between January 2020 and December 2020 and compared to number of same category CS before induction of Cooks Balloon as IOL method in same hospital during January 2019 and December 2019.
Method: Patients were identified using the Badgernet record (system used to keep record of all ANC and postnatal patients) for year 2020 and collecting data from medical records for year 2019.
Results: Total number of CAT1 LSCS was 124 in 2019 (before Cooks ballon use) and there was only 1 LSCS due to cord prolapse. In 2020 Number of CAT1 CS was 123 and due to cord prolapse were 8, and 4 out of these 8 had Cooks balloon induction.So Cooks balloon as method of IOL increased number of CAT1 cord prolapse CS by 3.5 times. Which is signifant.
Audience Take Away:
- Decision of balloon or Process should be made by senior MW/Dr after palpation abdominally and VE assessment.
- All patients must have recent presentation scan.
- If on P/A or P/V examination head is still high or not well fixed then Propess should be preferred over balloon.
- P/P 4/5 or more should not be sent home with balloon as they are at increased risk of Cord prolapse after SROM.
- Uterine balloon volume can be kept at 40mls or less as its associated with less risk of cord prolapse.
