How effective is a Foley Catheter for dilating the cervix: features of use

Indications and contraindications

In a number of situations, it becomes necessary to induce contractions in a woman in a non-natural way. Obstetricians do not often choose to use a Foley device, but for a number of indications a catheter may be necessary to induce labor.

post-term pregnancy for more than 7-10 days;
multiple pregnancy, in the absence of contractions after 38 weeks of pregnancy;
disturbances in the functioning of the cardiovascular system;
late toxicosis of severe form - gestosis;
closed uterus after the onset of natural contractions;
some diseases of the endocrine system - diabetes;
fetus weighing more than 4 kg;
polyhydramnios;
hypertension.

There are physiological factors that prevent the use of a catheter during pregnancy. Before proceeding with artificial stimulation of the uterus, it is necessary to exclude a number of contraindications.

bacterial infections and inflammation of the vagina;
bleeding;
rupture of the membranes;
malposition.

In these cases, inserting a catheter into the uterus will provoke a number of complications. For example, when a tube is inserted, bacteria and infections are transferred directly to the fetus. This is not a necessary consequence, but doctors try to avoid any risk and choose another alternative method.

Contraindications to epicystostomy

There are relatively few contraindications to suprapubic catheterization:

small bladder capacity (microcystis) - risk of unintentional damage to the intestines or blood vessels,
malignant tumors of the bladder,
active infection of the skin, urinary system,
severe coagulopathies,
osteomyelitis of the pubic bone.

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Foley catheter for cervical dilatation

According to official statistics, only in 7% of cases gynecologists identify the need to stimulate the dilatation of the uterus. Self-stimulation at home is not recommended; the procedure should take place in the maternity hospital. A woman has a Foley catheter placed to dilate her cervix before giving birth. The manipulation is complex and requires a high level of qualifications of the obstetrician.

Indications and contraindications

Indications:

post-term pregnancy for more than 7-10 days;
multiple pregnancy, in the absence of contractions after 38 weeks of pregnancy;
disturbances in the functioning of the cardiovascular system;
late toxicosis of severe form - gestosis;
closed uterus after the onset of natural contractions;
some diseases of the endocrine system - diabetes;
fetus weighing more than 4 kg;
polyhydramnios;
hypertension.

Contraindications

bacterial infections and inflammation of the vagina;
bleeding;
rupture of the membranes;
malposition.

Stimulation setup

The installation process of a Foley device is painful and requires the most qualified approach. In order for a catheter to be inserted painlessly in the maternity hospital before childbirth, you need to ask only an experienced obstetrician-gynecologist. When inserting the tube, the doctor must act as carefully and meticulously as possible so as not to increase pain.

Installation algorithm:

a thorough analysis of contraindications is necessary;
mandatory disinfection of genital organs is carried out;
gynecological speculums are installed;
by clamping the tube, the doctor inserts a catheter into the cervix;
attach the device to the inner wall of the thigh;
the part of the tube that remains is carefully placed in the vagina.

The purpose of the Foley device is to stimulate labor with a balloon located at one end of the tubes. It is this element of the catheter that plays a fundamental role during childbirth.

How does a cervical dilatation balloon work:

after installation, the obstetrician pours 10 ml of liquid inside through the valve;
the liquid flows through a tube into the balloon, gradually inflating it, turning it into a ball to dilate the cervix;
due to the pressure of the balloon on the uterus, its walls begin to be stimulated;
tone and motility increase, the cervix expands, and the fetus strives to free itself.

How long does it take for contractions to start after a Foley catheter? Contraction of the uterus begins in the first 6 hours after installation. Sometimes after just 1 hour the fetus is ready to be born. In some cases it takes up to 8 hours or more. After 12 hours of no signs of labor, there is a high probability of the method being ineffective.

Staying inside a Foley balloon to dilate the cervix during childbirth is permissible for no more than 24 hours. If contractions do not occur, then two courses of action are possible: either mandatory replacement of the device (an extremely rare case), or the use of other methods to open the uterus.

Only a doctor should remove the catheter. First you need to completely remove the contents of the can by releasing the clamp and smoothly pull the device out by the tube. Carefully inspect for any foreign matter.

The Foley stimulator can be used repeatedly, but it requires special care. Processing and disinfection occurs after each use. The device must be disassembled for cleaning. The outer coating of all components is treated with an alcohol solution, and the inside is thoroughly washed with sodium chloride.

NEW GUIDE “Zhukovsky’s vaginal and uterine catheters. Synergistic effect of catheters in stopping bleeding." Author: Ph.D. Zhukovsky Ya.G.

Effective compression of the lower uterus, cervix, upper vagina and their respective parametriums can be achieved completely non-invasively using only mechanical means. This area can be compressed using two volumetric elastic spherical objects, for example, two balloons filled with a solution, one of which is placed in the uterus and the other in the vagina. The two-balloon Zhukovsky tamponade catheter provides the ability to gently apply pressure to the lower part of the uterus and related blood vessels.

In the photo: Zhukovsky's controlled balloon tamponade - two-balloon module (blue - uterine catheter, transparent - vaginal catheter).

The vaginal catheter is attached to the uterine catheter when using UBT

to increase the effectiveness of stopping postpartum hemorrhage. To increase the effect of compression, a precise algorithm for installing a double-balloon UBT catheter was developed. This technique is based on securing the vaginal catheter into the vagina at the maximum possible height so that it adheres to the vaginal vaults and expands them, and also aligns the cervix with the surface of the balloon; only after this the terminal opens and the required amount of solution begins to flow into the pre-installed and partially filled uterine balloon. The expanding uterine balloon is moved towards the secured vaginal catheter until a tight seal is achieved.

Image: placenta previa. Mutual pressure between the balloon and the lower part of the uterus

A double-balloon UBT installed in the birth canal creates the necessary pressure on the bleeding lower part of the uterus and on the vessels supplying blood to this area, eliminating the need for dangerous and complex surgery.

The success of the technique was confirmed during a Doppler ultrasound examination of the lower part of the uterus, during which it was established that there was no bleeding in this area in the presence of a double-balloon UBT in the birth canal. This approach to stopping PPH uses a simple, intuitive tool that even a young and inexperienced doctor can use quickly and easily. It provides obstetricians with new options for conservative management of bleeding, allowing patients to avoid hysterectomy in cases where they can do otherwise and thus preserve their reproductive function.

The well-vascularized lower part of the uterus has minimal muscle contraction and is not the most suitable site for surgical intervention. Controlled and safe compression, which is provided by two elastic, smooth spherical UBT balloons, is similar to the natural mechanism of hemostasis. If the muscle fibers are too weak to constrict the open vessels, balloons that apply pressure to the lower part of the uterus are the optimal means of stopping PPH and allowing the subsequent blood clotting process.

The vaginal module, which performs the task of simulating a closed cervix, must be installed in the birth canal at the level of the uterine os. This should not be interfered with by the filled uterine catheter in the uterus. Therefore, approximately 80–100 ml of solution should be released from the uterine balloon first. As a result of partial emptying, the lower pole of the uterine balloon goes deep into the uterine cavity, freeing the plane of the uterine pharynx for the vaginal module. The remaining solution in the balloon is preserved during the connection of the vaginal module by closing the open end of the catheter with a plug conductor.

After the vaginal module is firmly installed at the proper depth in the vagina, the solution is added to the uterine balloon. The uterus itself determines the required volume of solution for the uterine balloon: the solution enters the balloon from the reservoir until the expanding balloon comes into contact with the uterus. The force of pressure of the balloon on the walls of the uterus and its vessels bleeding into the cavity depends on the height of the reservoir above the balloon.

In this case, the uterine balloon again increases in size and its lower pole begins to move into the open uterine os towards the installed vaginal balloon. At the level of the uterine pharynx, the uterine and vaginal catheters are joined, which ensures retention of the filled slippery uterine balloon within the uterine cavity when the uterine pharynx is open .

Thus, using the vaginal module, a closed cervix is simulated when it is actually dilated.

In addition to reliable retention of the uterine balloon in the uterine cavity, when a tight interaction between the two balloons is achieved, additional mechanisms are launched to stop postpartum hemorrhage, including interballoon compression of the lower segment of the uterus .

a personal double-balloon catheter
assembled from two catheters directly in the birth canal and individually adjusted to the patient’s anatomical parameters is the presence of a wide gap between its axial tubes, standing coaxially.

Thanks to this gap between the two catheters, the obstetrician can quickly assess the effectiveness of stopping bleeding. In the event of ongoing uterine bleeding, blood will immediately flow out through the lumen between the axial tubes of the catheters. As a result, the obstetrician is promptly informed about defective hemostasis and the possibility of hidden bleeding is excluded .

In some clinical situations, the emptied uterine catheter can be easily removed through the wide axial tube of the filled vaginal catheter, leaving only one catheter for a longer period.

The new double-balloon UBT is able to adapt to the unique anatomical structure of any patient; in fact, it can be considered individual. An important distinguishing feature of a double-balloon shock collar is the presence of a large gap between the axial tubes, due to which the obstetrician is able to immediately recognize the ineffectiveness of the shock collar.

In the image: the gap between the axial tubes of the catheter. Hidden bleeding prevented

The vaginal module is connected to a filled uterine catheter installed in the uterus.

PHASE I

. Disconnecting the tube with reservoir from the uterine catheter

1. Close the terminal on the tank connecting tube. 2. Pinch the catheter shank with your fingers. 3. Remove the adapter with the connecting tube of the reservoir from the pinched shank of the catheter and hang the blocked tube on the stand.

STAGE II.

Partial emptying of the uterine catheter

1. Having loosened the finger clamping of the shank, release 80–100 ml of solution from the uterine catheter into a measuring container placed between the patient’s legs. 2. Insert a plug conductor into the pinched shank of the uterine catheter.

STAGE III. Installation of the vaginal module

1. Insert the plug conductor inserted into the shank of the uterine catheter into the lumen of the axial tube of the vaginal module. Place the vaginal module on the plug conductor on the axial tube of the uterine catheter 2. Using the plug conductor located in the lumen of the axial tube of the vaginal module, connected to the axial tube of the uterine catheter, slowly insert the vaginal module deep into the vagina (to the level of the uterine pharynx). As a result, the proximal end of the uterine catheter must protrude from the vagina further than the proximal end of the vaginal module. 3. Holding the yellow axial tube of the vaginal module in this position, use a syringe-pump to fill the vaginal balloon with a solution of 150–200 ml and close terminal No. 2 on the purple insertion tube of the vaginal module.

STAGE IV. Restoring the volume of solution in the uterine catheter

1. Pinch the shank of the uterine catheter with your fingers. 2. Remove the plug guide from the shank of the uterine catheter. 3. Insert the adapter of the connecting tube of the reservoir into the shank of the uterine catheter. 4. Open terminal No. 1 on the tank connecting tube. 5. Simultaneously with the decrease in the solution, add new portions of it to the tank until the solution level stabilizes in the middle of the tank.

Stabilization of the solution level in the reservoir indicates that the uterine balloon has come into contact with both the walls of the uterine cavity and the vaginal module covering the open uterine os. This point is the starting point in the method of complex use of uterine and vaginal balloon catheters for postpartum hemorrhage.

6. In the case of blood flowing through the lumen between the axial tubes of the installed catheters, the height of the reservoir placement should be increased stepwise by 5–10 cm, with evaluation of the result. 7. Monitoring the correct position of both balloons in the birth canal is carried out systematically using ultrasound. 8. The method of complex use of uterine and vaginal catheters usually takes no more than 3 hours. However, there is experience in leaving the vaginal module for a longer period. 9. The emptied uterine catheter is removed through the axial tube of the vaginal module left in place.

How is the procedure done?

Awareness will best protect you from unnecessary worries. Therefore, if you know that you will have a Foley catheter inserted, the instructions for use should be carefully studied. This way you will clearly know what your doctor is doing at each stage.

Usually this procedure does not take much time. The biggest disadvantage is the severe pain during insertion and the resulting discomfort. If the doctor performs the procedure not for the first time, then the installation of the catheter will take place very quickly.

First of all, the obstetrician evaluates all indications and contraindications for this procedure. The surface of the vagina is treated with a disinfecting solution. Special sterile mirrors are attached.

Holding the catheter with a clamp, the obstetrician guides it into the cervix. The main thing is to place the inflatable balloon above the internal pharynx at this time.

Next, take a 10-milliliter syringe and use it to inflate the balloon to the desired size. This is the principle of operation of the catheter. A water balloon increases the tone and motility of the mother's uterus; it puts pressure on it and expands it.

An even more effective method is if the doctor injects a saline solution into the fetal bladder through a special tube.

The catheter is attached to the inside of the thigh using a special tape. At this time, the remaining tube is rolled into a ring and placed in the vagina until contractions begin. But no more than a day. If these measures do not help, then labor should be stimulated with oxytocin.

If contractions begin, the Foley catheter (the instructions for use insist on this) must be removed. Call a doctor immediately. He will place a special syringe in the balloon and use it to draw out all the liquid. Afterwards, the tube is clamped with a special clamp and removed from the vagina. Be sure to entrust this action to a medical professional; when removing the catheter yourself, you may spill water or saline solution inside the vagina. This will most likely cause an infection.

It is worth remembering that a Foley catheter is significantly different from a conventional urinary instrument. They are used in a similar way, but in the case of a catheter, the outcome of the birth may depend on proper use.

As a rule, one does not use such a device at home, but only in a hospital room when labor is about to begin. However, even if you are surrounded by medical personnel, it does not hurt to know how to use and care for the catheter.

Foley catheter to induce labor

The button for the cut is not displayed either in the mobile or in the full version, sorry if something is wrong. Labor began on a weekday in July before lunch with the breaking of the waters. This was the last scenario I wanted, but at home, and not somewhere in a public place, sorry for the details, I was just changing my underwear, and went to wash my long-suffering hemorrhoids with cool water, and somewhere between the bathroom and the drawer with underwear, water poured out of me. warm liquid, realization came quickly. Go to the bathroom again, get ready for the maternity hospital, shave your legs, etc. And the water keeps leaking, transparent and with thin dark hair! Apparently the child had shed inside, it was kind of tinny. She called the gynecologist and asked in a trembling voice how much of a hurry should she have if her water broke? He says get ready and leave. OK. I have packages ready for another 30-odd weeks, I called my husband, I’m sitting waiting, it’s not far to go, for some reason there are no contractions... My husband arrived, pale, but he doesn’t seem to be freaking out, I warn you that you don’t need to drive me in the oncoming lane, it doesn’t hurt me and It’s like I’m not giving birth at all. At the stupid maternity hospital we unloaded outside the gates, we had to walk on foot with our trunks, because... Private vehicles are not allowed into the territory. There, in some turmoil in the reception area, I changed into my shirt, sent my husband, I was waiting for them to take care of me, the doctor came, felt me not in the chair, but right on the couch, it was painful, and picked something there until I bled. Grit, the disclosure is purely symbolic, let's go hang out in the prenatal room, look at the CTG, wait for contractions, if not, we'll be stimulated. The prenatal room is a cramped room with 3 tall beds. One girl is lying waiting for her foley catheter, I settled down, they took a CTG - everything is fine, but there are no contractions, two hours later I sign the papers for stimulation, the portal to my personal hell for the next 8 hours, half an hour after taking it, I started to feel some severe pains in the stomach, with an interval of 5 minutes, but quite tolerable, for another hour the interval became 2-3 minutes and there was clearly no time for fun. With such a sudden influx of pain, I stupidly forgot all the techniques from the training courses, how to help myself relieve pain, how to breathe (there were a lot of different ways, such as short inhalation, long exhalation, and also counting time). The only thing I remembered was the simplest technique I saw on YouTube from Alexander Kobas: inhale through your nose, exhale through relaxed lips. That's all! In my stomach, it feels like I’m being cut from the inside by rusty, jagged scissors, and I’m only thinking about one thing: “how it hurts, inhale and exhale, I’ll breathe right now, inhale through my nose, exhale through a relaxed mouth.” I spent the entire contraction on my feet, intuitively twisting my hips in a figure eight, just to somehow distract my body from the sensations in my stomach; this movement happened somehow by itself. Lying down for the next CTG was just real torture, but I kept breathing, the baby’s pulse was fine. I remember that I wanted something small, but the toilet was in the corridor, I somehow crawled out there, I remember that it was hard to sit on the toilet with contractions, I don’t even remember whether I was able to go in the end. It was eight o’clock, the doctor promised to appear just after this interval, I can’t anymore, it feels like the contraction is just continuous, it crawled to the nurse’s station, I thought about begging for anesthesia, I ask in a slurred voice, where is the doctor? In response: everyone left. Well, damn.. Another hour in hellish oblivion, cold sweat with the thought only of inhalation and exhalation and where is the doctor? Finally, my dear one came, I felt it again on the couch, the opening was almost complete, now we’ll assign it to the labor room, I felt suddenly better and it was as if the intervals had increased again, giving me a break. A girl with contractions nearby was moaning while standing in a kneeling position with her butt up, the doctor swore at her heavily. In the labor room, the doctor said go and push, but I don’t even feel any pushing, I don’t even feel the cherished feeling “I want to poop.” I wandered around the labor room for some time, it became scary, because the end was near, but there was no pushing, the pain was still there. The midwife came, sat me down in a chair, told me the scenario of actions, realized that there was no pushing, and the intervals of contractions began to increase a little again, they connected an IV with oxytocin, and the midwife began pushing during the contraction; honestly, I didn’t have enough patience and breathing space to push as much as she commanded. and I relaxed before. All her explanations of how to push without being in your face passed by, I pushed with everything I could, just so that they would leave me behind. Apparently the process was delayed. More people began to appear in the family room, and the doctor came. The head seems to be stuck at the exit, people are already increasing the intensity of passions, they suggest pushing as if in the toilet, but try really hard, otherwise the child doesn’t fit and it’s not good for him. I simply grabbed all my strength and strained my whole body, in addition to this, the doctor pressed with his elbow in the upper part of the abdomen, as a result, at the same time, apparently, the head fell out (shameful ) and blood sprayed out of the nose in two streams. Then I remember everything somehow vaguely, the shoulders went away without any problems, I decided that that was it, I was exhausted, poor unfortunate thing, and only after I thought that the child was not screaming, out of the corner of my eye I saw that the doctors on a separate table were performing some manipulations with him, with some kind of unit with a mask. I hear her groan, reluctantly, weakly, unsure and dissatisfied. The child was quickly wiped down, examined, the parameters were given, he was swaddled, and at this time one external tear was being stitched up. They hand a round-faced, wrinkled matryoshka doll into her arms, 7/8 apgar, she still didn’t scream normally, she was lying there groaning. It felt like the entire period of the birth itself took about 40 minutes. They gave me a mobile phone and went our separate ways, leaving the three of us with an oxytocin drip. We lay there for two hours, then they took us to the ward, it was about 11 pm, it was dark, quiet, people were sleeping, I was lying in the darkness ineptly trying to insert a breast, and only somewhere at this stage I began to come to my senses and understand that my life was no longer quite mine will never be the same. I can’t say that I’m terrified of childbirth, but contractions are very painful, and childbirth is very difficult physically, but feeling sorry for yourself in this process is making things worse for your child. I decided right away that I wanted the same thing and once again - it’s easy, now I hope to implement the decision in January 2021 Only this time I will sign a contract with a doctor, I realized that it would be easier if during the first birth I had a professional within reach who didn’t really care how my process is going, and who is interested at least financially and reputationally. To everyone who is waiting - patience, strength, good doctors and healthy children, of course!

How to care?

A woman who has a Foley catheter is usually told how to properly care for it throughout the day. The rules are explained by the doctor who installed the device. You need to follow them strictly if you want to give birth to a healthy baby and quickly bounce back after childbirth.

First of all, a woman needs to remember about hygienic requirements. The skin around the installed medical device must be clean. Each time, before touching the external genitalia, you should thoroughly wash your hands with warm water and soap.

There is no need to remind you once again that panties must be exceptionally clean. Briefs should not compress or deform the catheter.

It is important to ensure that this does not happen during movements. But it is usually not necessary to rinse or reinstall the catheter when inducing labor - its use in obstetrics is disposable

For more information about what a Foley catheter is, see the following video.

Varieties

Which Foley catheter to use during pregnancy from all the variety offered by modern medicine is determined by the doctor after examining the cervix.

2 way

A two-way Foley catheter is often used, which is considered a classic instrument. It has only one common channel. It is used to pump water and introduce medicinal solutions into the balloon. As for the material, it is better to choose silicone, as it has a number of advantages:

biocompatibility with body tissues;
chemical inertness;
minimal surface tension;
thermal and chemical stability;
hydrophobic properties;
does not cause adverse (including allergic) reactions.

The only drawback that a silicone 2-way Foley catheter has is its relative high cost compared to other devices. However, even at this price, this method of inducing labor remains the cheapest.

3 way

The stimulation of labor will be much better if a three-way Foley catheter with a separate channel is used, through which special medicinal solutions can be injected into the cervix.

Female

To avoid damaging the cervix, doctors prefer to use a female Foley catheter to induce labor, which is shorter and therefore less traumatic.

To choose the right Foley catheter during childbirth, you definitely need to consult a specialist. You can independently purchase a device that is completely unsuitable for cervical stimulation. This can greatly harm both the baby and the mother herself. Moreover, the cases when they decide to use it are very limited due to the large number of shortcomings. There must be serious medical indications for its use.

Installation of a Nelaton catheter or catheterization of the bladder

A catheter (product category on the website “Catheters”) is a tube that is inserted into the natural channels and cavities of the body for emptying, administering fluids, contrast agents, parenteral nutrition and lavage, as well as for inserting surgical instruments through catheters. Inserting a catheter is called catheterization.

Nelaton catheter (click to find out price/buy) is a type of urological (urethral) catheter used primarily for drainage of the bladder and upper urinary tract (ureteric catheters, also called catheter-stent or ureteronic stent).

Catheters are usually made of plastic (medical PVC) or silicone, they may contain a coating that prevents bacterial adhesion or special lubricants to ensure a softer installation of the catheter. Silicone catheters are used more often for long-term catheterization due to the fact that they have a larger internal diameter than plastic ones. Such catheters are less traumatic. Less common are metal catheters, straight (for women) and curved (for men), which are more traumatic. In modern urology, various types of elastic urethral catheters are used: Nelaton (similar to the Robinson catheter), Thiemann, Pezzera, Foley, Malekot. Catheters come in different sizes. The sizes are determined by the French Charrière jackal (designated CH or CH/FR), which contains numbers from 1 to 30, with each unit corresponding to 0.33 mm in diameter, which indicates the circumference in millimeters. For example, a 30 CH/FR catheter has a diameter of approximately 10 mm and a circumference of 30 mm.

a) conical with one hole, Nelaton;

b) Robinson catheter;

c) Whistle-tip urethral catheter.

d) Timman olive tip catheter

e) Malekot catheter, self-fixing, 4-winged.

e) Malekot catheter, self-fixing, 2-winged.

g) Pezzer catheter, self-fixing, used for epicystostomy.

h) 2-way Foley catheter, entrance for balloon inflation in the bladder cavity (i), channel for urine outflow (ii).

i) 3-way Foley catheter, entrance for inflating the balloon in the cavity of the bladder (i), channel for urine outflow (ii), channel for connecting the bladder flushing system (iii).

Nelaton catheter is a catheter used for short-term catheterization of the bladder, determination of residual urine, or for introducing various drugs into the bladder (instillation). The tip of the catheter is rounded, for atraumatic reasons, and has one or two side holes.

Foley catheter – characterized by the presence of a balloon with a capacity of 5 to 70 ml , located at the top of the instrument designed to hold the catheter in the bladder. The tip of the catheter can have different lengths. A Foley catheter balloon with a capacity of 30 to 70 ml can also be used to stop bleeding when removing prostate adenoma. In a two-way Foley catheter, one channel is used to drain urine and the other is used to inflate the balloon. To carry out constant irrigation (irrigation, watering) of the bladder after transureral resection (TUR) of the prostate and with severe hematuria, three-way Foley catheters are used. The Thiemann catheter has a rigid, curved tip that allows passage of obstructions in the urethra caused by striated sphincter spasms, urethral stricture, adenoma, or prostate cancer. There are curved catheters with a fixing balloon. The Pezzer catheter is currently most often used as a cystostomy drainage. The end of the catheter is a mushroom-shaped extension with shape memory, which expands when inserted into the bladder. To prevent displacement, the catheter is fixed with a patch or ligatures to the skin of the anterior abdominal wall. The Malekot catheter is similar to the Pezzer catheter, but unlike it has wider drainage holes.

When catheterization is difficult, metal conductors are less often used, which can be given varying degrees of curvature. And even less often (with strictures of the urethra), an open-ended catheter is inserted into the bladder through a flexible guide wire.

BLADDER CATHETERIZATION IN MEN

The technique of inserting a catheter into the bladder is more difficult for men than for women. With the patient in the supine position with slightly bent legs, the head of the penis is grasped with the middle and ring fingers of the left hand along the coronary groove from the sides (without squeezing the urethra) and slightly pulled in front so that the folds of the mucous membrane of the urethra are straightened. In this case, with the index and thumb of the same hand, the external opening of the urethra is slightly pushed apart. After antiseptic treatment of the external opening of the urethra and the head of the penis, 10 ml of a lubricant gel containing 1–2% lidocaine (catedgel, instillagel or lidochlor) can be injected through the urethra. For pain relief, you can use the exposure of the gel in the urethra for 5–10 minutes. Then the catheter, generously lubricated with sterile vaseline oil or synthomycin liniment, is passed along the urethra with the right hand, intercepting it with sterile tweezers. Modern disposable catheters are made in such a way that when inserted into the urethra they soften and allow the catheter to be inserted without prior preparation, including in public toilets. Nelaton catheters are also available with a special coating (polyvinylpyrrolidone), which acts as a lubricant to facilitate catheter insertion. The criterion for correct catheterization is the appearance of urine through the catheter. The absence of urine output from the catheter is a contraindication to filling the catheter balloon, since this can lead to damage and even rupture of the prostatic or other part of the urethra. In case of severe spasm of the striated sphincter, increase the amount of administered lubricant gel and exposure time, and insert the catheter with a deep breath. In rare cases, sedatives may be necessary. In case of difficulties caused by urethral stricture, catheterization is carried out without excessive force, since this can lead to perforation of the urethra. To diagnose urethral stricture, retrograde urethrography is used; if extensive narrowing is confirmed, it is more appropriate to divert urine by puncture cystostomy.

The technique of inserting a metal catheter in men is even more complex and requires a certain skill and great care. After treating the external opening of the urethra and lifting the head of the penis up with the fingers of the left hand, pull it parallel to the inguinal fold. With the right hand, the instrument is inserted down the urethra with the “beak” down to the external sphincter of the bladder, where the obstruction is encountered. Then the penis, together with the catheter, is transferred to the midline of the abdomen at the same angle to the anterior abdominal wall (almost horizontally) and they begin to slowly lower the outer end (pavilion) of the instrument, continuing to insert its inner end deeper and pulling the urethra onto it. After overcoming slight resistance, the catheter passes through the posterior urethra into the bladder. The catheter pavilion is located between the patient’s legs, the ability to freely rotate the instrument along its longitudinal axis is evidence that its inner end is located in the bladder. Another confirmation of this is the discharge of urine through the catheter. Forcibly inserting a metal instrument into the bladder is extremely dangerous due to the possibility of perforation of the urethra or bladder neck. The danger of such a complication is especially great if there is an obstruction along the urethra and bladder neck (adenoma and prostate cancer, urethral stricture). Due to traumatic and inflammatory complications, indications for bladder catheterization in men with metal catheters should be extremely narrowed.

Modern plastic catheters simplify the catheterization procedure and allow it to be used anywhere.

CATHETERIZATION IN WOMEN AND CHILDREN

Catheterization is much easier for women than for men. With the patient in a supine position with her legs slightly bent and spread apart, after treating the external genitalia, the labia majora are spread apart with the index finger and thumb of the left hand. After identifying the external opening of the urethra, a generously lubricated catheter is passed through the urethra. The criterion for correct installation is urine output through the catheter. If the external opening of the urethra cannot be detected, then you should insert a finger into the vagina and move the back wall downwards. The catheterization technique in girls is similar to that in adults, using 8–12 CH catheters. In boys, the 8 CH catheter is most commonly used.

CATHETERIZATION OF THE BLADDER AND URETER

There is diagnostic and therapeutic catheterization. Diagnostic catheterization of the bladder is used in cases where it is impossible to determine the presence of urine in the bladder by other methods. Unilateral diagnostic catheterization of the upper urinary tract (UTT) is performed when performing retrograde pyelography to establish the level of obstruction in the ureter and determine the Chevassus symptom.

Bilateral diagnostic catheterization is used for separate collection of urine from the kidneys with bilateral lesions, to determine the side of the operation, and differential diagnosis of anuria (renal and postrenal).

Therapeutic catheterization is one of the methods of drainage of the urinary tract, which is used in modern urology. Bladder drainage is used for obstructive diseases, such as adenoma, prostate cancer, leading to acute or chronic urinary retention (ischuria).

For obstruction of the upper urinary tract, one of the drainage methods is catheterization. It is used more often to prevent the occurrence or development of acute obstructive pyelonephritis. Having passed the ureteral catheter (stent) above the obstruction and thus restoring the passage of urine, treatment of the infectious and inflammatory process can begin. Also, it is necessary to remember that catheterization of the ureter with a stent above the obstruction is an effective way to treat renal colic that is not relieved by medicinal and physical methods. After the outflow of urine is restored, the hydrostatic pressure in the pelvis decreases, and colic usually stops.

During extensive gynecological operations, complex pathologically altered topographic-anatomical relationships of the pelvic organs and lower parts of the ureters, as well as the bladder, cause damage to the latter, which often occurs even among experienced surgeons. The danger of damage to the ureters during extended surgical procedures on the pelvic organs makes bilateral catheterization of the ureters before surgery extremely advisable. Dense ureteral catheters are well identified by palpation through the wall of the ureters; they serve as a fairly clear guide, allowing the surgeon to avoid damaging them.

For long-term drainage of the upper urinary tract, a special ureteral catheter-stent with two curls is used. The upper curl is installed in the pelvis, and the lower one in the bladder; Thus, the stent does not move when the patient changes body position and practically does not prevent him from leading a full lifestyle. With the help of such catheter-stents it is possible to drain a person’s urinary tract for up to a year

Acute urinary retention occurs in elderly patients and is most often caused by prostate adenoma or cancer. Often the patient’s intercurrent background does not allow radical surgical intervention. The only way to divert urine in this case is cystostomy. However, the presence of a cystostomy significantly reduces the patient’s quality of life. Recently, with the development of new synthetic materials, it has become possible to produce a urethral stent, which, when installed in the prostatic part of the urethra, allows you to restore urination. There are also absorbable stents, which spontaneously collapse after several (4-6) months, and permanent ones, most often made of nitinol (a special metal alloy), which can be installed for life.

The Nelaton online store offers you a wide range and selection of catheters of different types and manufacturers in thematic sections, by method of application, as well as in a general combined section that includes all types - catheters/probes (use the filter on the right for convenience).

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Possible complications

Doctors have an ambiguous attitude towards this medical device also for the reason that it can cause complications. They can be either immediate or delayed.

The emergency category includes situations in which problems are observed with the catheter itself after insertion. These are a variety of troubles - from the cylinder falling out to the leakage of liquid pumped into it. Many complications relate not so much to the catheter itself, but to the fact of inducing labor. Recently, it has been believed that interference in the affairs of nature does not benefit either the mother or the child.

Due to the fact of induction, weakness of labor forces often develops, in which contractions are ineffective, do not lead to the opening of the cervix or stimulate a very slow opening. Weakness can also develop in the second stage of labor - pushing.

Sometimes women who had a Foley catheter placed before childbirth have a more difficult time recovering from the birth process and are more likely to develop infectious and inflammatory diseases of the uterus and cervix.

Labor can begin, according to reviews, even before the catheter is removed from the cervical canal, but this situation can be resolved quite easily, because during a gynecological examination the catheter is removed quickly.

Catheter care

Any doctor, before inserting a catheter, is obliged to explain to the patient how to live with it for the next few hours. Detailed information is also in the instructions; it describes in detail how to use a Foley catheter. Dimensions and a table from which you can choose the optimal one are also there.

In order to avoid complications, you need to carefully monitor the instrument at all times. Everyone can follow the rules of care.

The catheter itself and the skin around it must be disinfected. Also wash your hands thoroughly with soap. The risk of infection is very high. However, remember not to wash the area directly around the device tube.

Make sure that the catheter balloon does not fall out prematurely. Wear loose underwear, preferably cotton, that will not restrict movement. Do not allow the tube to become kinked or compressed.

If a woman in labor begins to experience discomfort with the catheter, such as burning, chills, abdominal or back pain, the doctor should be informed immediately.

Application

You cannot install a catheter yourself; this can only be done by a medical specialist with a status of at least a doctor. He is the one who has strict instructions that he must follow during the installation of the catheter.

The procedure is quick, does not cause discomfort, and is performed in several stages:

First of all, all possible risks are assessed, the pros and cons are weighed. After this, all data is entered into the history of the woman in labor.
The genital tract through which the fetus will pass is disinfected.
All instruments used during the procedure must be sterile. The specialist works in sterile gloves.
The thin end of the catheter is inserted into the cervical canal of the woman in labor through the vagina so that the balloon is located just above the entrance to the reproductive organ.
Using a syringe, 10 ml of water is injected into the balloon.
The expanding balloon puts slight pressure on the cervix, stimulating its opening and the onset of labor. An additional specialist can administer saline through the catheter.
The end of the catheter that remains outside is fixed with an adhesive plaster on the woman in labor’s thigh.
The catheter to dilate the cervix before childbirth is left in the cervical canal for 24 hours. If during this time labor is active, then it is removed. If contractions have not started, the catheter is removed and stimulation is carried out using other alternative methods, for example, medications.

A woman needs to be careful during the day after the catheter is installed. It must not be removed, otherwise it may cause infection.

The catheter must be looked after. The doctor should tell you about all the rules before installation.

Care involves the following manipulations:

The skin around the catheter and the device itself must be clean.
Hands should be washed thoroughly before touching the device.
The area around the tube does not need to be washed.
The catheter cannot be removed.
While the catheter is in effect, it is necessary to wear high-quality underwear made of cotton fabric, which should not restrict movement.
Try not to bend or squeeze the tubes.
There is no need to flush the catheter during labor induction.

If after installing the catheter you experience discomfort, burning, itching, or chills, you should definitely inform your doctor about this.

A medical professional should also remove the catheter:

Initially, the clamp is loosened;
then the balloon is removed;
Disinfection of the genital organs of the woman in labor is mandatory.

There are times when one woman needs to be re-catheterized, but there must be specific reasons for this. The decision to re-install should be made by the attending physician, who will first take into account the peculiarities of the course of labor.

There are times when the balloon falls out on its own. In this case, the woman needs to inform the gynecologist about this. After this, a decision is made to completely remove the balloon or reinsert it.

Action

The structure of the catheter is quite simple. This also applies to the packaging, thanks to which you can remove the device from it without touching the tubes.

The design is simple:

a balloon responsible for dilation of the cervix during labor;
tip made in the shape of a cylinder;
a connector that serves for a long-term connection between the catheter and the cervix.

A Foley catheter to dilate the cervix before childbirth is placed only with the permission of the gynecologist. Thanks to its use, it is possible to expand the entrance to the uterus to 4 cm. After its installation, contractions begin within 1-3 hours.

A catheter is installed in several cases:

to stimulate the walls of the reproductive organ;
significantly expand the neck diameter;
speed up the onset of contractions.

Stimulation of labor using a catheter occurs as follows:

a balloon filled with liquid creates pressure on the uterus from the inside, resulting in a bursting effect and a significant increase in the tone of the reproductive organ;
after inserting the catheter, contractions occur on average within 6 hours, but this time period varies from person to person.

Often after installing the catheter, contractions do not occur for 5 hours. In this case, stimulation with drugs is additionally prescribed, for example, oxytocin is also administered intravenously. This set of measures allows you to increase the effectiveness of catheter stimulation several times.

A catheter for dilating the cervix before childbirth, if you follow the Russian Ministry of Health, is allowed to be used in the following cases:

a woman in labor carries the fetus beyond 41 weeks;
the chronic illnesses of the woman in labor have worsened, in which prolongation of pregnancy can lead to serious consequences;
the woman has serious problems with her heart function;
the condition of the fetus has deteriorated significantly;
leakage of amniotic fluid is observed, but contractions are not observed;
pregnancy with twins or more fetuses;
severe forms of gestosis;
diseases of the endocrine system;
unstable blood pressure;
labor activity is weak;
large fruit or polyhydramnios.

Catheter placement

A catheter for dilating the cervix before childbirth is installed using a special gynecological speculum. The vagina is pre-treated with a disinfectant. A tube is inserted into the cervical canal of the pregnant woman. To avoid infection, the catheter should not be handled by hand. The balloon is placed in the internal os of the uterus. To inflate it, you need to pump it with saline solution. To do this, the doctor takes a syringe and pours liquid through the tube. When the cuff inflates, the tone of the cervix increases and it begins to expand.

After this, the part of the device that remains outside is attached with a plaster to the woman in labor’s thigh.

The catheter can be left in place for a day. If during this period of time labor has not begun and the necessary dilatation has not been achieved, then oxytocin should be administered. If stimulation using this method is successful, the device itself falls out of the neck.

The woman in labor should not remove the catheter herself. Initially, you need to pump out the saline solution from the balloon, then clamp the tube and only then carefully remove the device. Only a doctor can do everything correctly.

Side effects

The catheter to dilate the cervix before labor may not work and contractions will not occur. In this case, the woman begins to worry, as a result of which additional “tightness” of the uterus is observed. In this case, it is worth doing everything possible to make the woman calm down, relax, and walk around the room.

There may be other reasons for the lack of effect from the catheter:

severe stress;
injury to the walls of the cervix;
inflammation inside the reproductive organ;
physical inactivity.

In all these cases, it is better to remove the catheter and find an alternative way to induce labor.

What is a Foley catheter

It is designed for urine outflow when long-term catheterization is necessary, more than 5 days. However, its structure allows it to be used to speed up labor.

Device characteristics

The structure of the device is thought out as much as possible. This also applies to its packaging, which allows you to get the device without touching its tubes.

The design of the device is simple. It consists of:

balloon, which is responsible for dilation of the cervix during childbirth;
cylindrical tip;
connector, which serves for long-term connection of the catheter with the cervix.

Appearance and dimensions

This device is a tube. At one end there is a balloon into which saline solution is subsequently injected to dilate the cervix, and at the other there is a device for introducing fluid with a special valve. Only high-quality materials are used to manufacture parts. The surface of the device is as smooth as possible, which ensures quick installation, high safety and comfort while wearing.

Such devices differ in size, as indicated by the corresponding color. These data are reflected in special tables that are kept by every doctor who uses these catheters in their professional activities. To induce labor, the female two-way one with a red tip and an outer diameter of 6 mm is most often chosen.

Indications for inserting a catheter into the abdomen

The most common indication for suprapubic tube placement is urinary retention when urethral catheterization is not possible.

Reasons for failure of urethral catheterization include:

BPH (large sizes),
false urethral meatus,
morbid obesity,
urethral strictures,
contracture of the bladder neck,
malignant neoplasms of the genitals,
Urogenital trauma causing urethral disruption and severe injury are common indications.

Sometimes a cystostomy is used for long-term urine diversion in cases of neurogenic bladder.

Complications

What problems may arise after installing a Foley catheter to induce labor?

The catheter balloon may fall out of the vagina prematurely, without causing toning of the uterus. In this case, either this method of stimulation is abandoned or the device is replaced with another.
The cylinder may leak. This indicates a valve malfunction. The device is being replaced.
Labor has begun, but the can is still inside. In this case, the catheter is removed by a nurse or doctor.
Too painful catheter insertion (not noted by everyone) is reduced by painkillers administered intravenously.

Recently, the use of a Foley catheter during childbirth has become less common. Modern innovative technologies in gynecology make it possible to carry out stimulation using other methods more effectively and safely for the health of both (mother and child). But if you still have to give birth with its help, there is no need to be afraid or worry. The main thing is that it should be performed by professionals, i.e. doctors in a hospital setting. Using this tool at home, even in strict accordance with the instructions, is fraught with dangerous consequences.

Catheter care

In order to avoid complications, you need to carefully monitor the instrument at all times. Everyone can follow the rules of care.

Make sure that the catheter balloon does not fall out prematurely. Wear loose underwear, preferably cotton, that will not restrict movement. Do not allow the tube to become kinked or compressed.

If a woman in labor begins to experience discomfort with the catheter, such as burning, chills, abdominal or back pain, the doctor should be informed immediately.

Possible complications

There may be some problems when using a catheter. Here are the most common ones.

Most often, complications arise due to the fact that the balloon falls out of the vagina prematurely. However, the desired effect is never achieved. In such a development of events, the device is replaced, or a fundamentally different method is used.

There are cylinders that leak. This means that the integrity of the valve has been compromised. The device needs to be replaced.

The can ends up inside when labor has already begun. The catheter must be immediately removed with the help of medical professionals.

The woman in labor experiences severe pain when the catheter is inserted. It can be neutralized with painkillers.

Induction of labor involves artificially inducing labor. This event is carried out at any stage of pregnancy, but most often during postmaturity or weak contractions and attempts.

Not every delay needs stimulation, so doctors analyze the situation strictly individually.

Medical indications for induction of labor:

Post-term pregnancy, especially if pathological changes in the placenta or abnormalities in the baby are detected;
Premature placental abruption, which poses a danger to the life of the fetus;
In some cases - late toxicosis;
Premature rupture of water leads to the penetration of infections through the cervix;
Diseases of a pregnant woman, for example, diabetes.

If the period has been delayed significantly, and the doctors have prescribed stimulation, then you can try to rush the child on your own.

Inducing labor at home involves the use of several alternative methods:

Acupuncture, or acupuncture. Very thin needles are inserted into specific points. According to Chinese philosophy, such actions stimulate the body's energy and affect certain organs and systems of the body. The procedure should only be performed by a specialist in this field;
Castor oil is used quite rarely to induce labor, as in addition to diarrhea it causes nausea and vomiting. In itself, this substance is a strong laxative. By stimulating the intestines, it affects the uterus, causing its contractions. Standard dose – 114 ml (mix with orange juice or ½ tbsp soda). The interval between the first and second doses should be 12 hours;
Curry. The spice acts, like castor oil, on the intestines and uterus at the same time. However, those who are not used to spicy foods may experience heartburn, although this is a fairly rare occurrence in the last weeks of pregnancy;
Pineapples. These fruits contain the enzyme bromelain, which helps soften the uterus. However, you need to eat at least 7 pieces. Side effect - a large amount of bromelain can cause diarrhea;
Medicinal herbs. You should consult a gynecologist about their use, since many plants are prohibited for pregnant women. Powerful cohosh and basil foliage can cause labor. However, official medicine is quite skeptical about such methods;
Homeopathic medicines. Before use, you should definitely consult a homeopathic doctor;
Raspberry leaves are used to strengthen weak contractions. Research has shown that they can significantly speed up the course of the second stage of labor and reduce the possibility of using obstetric instruments. It is recommended to start taking it at 32 weeks of pregnancy. In this case, just by the appointed date, a sufficient amount of necessary substances will accumulate in the body and begin to act. The leaves can be taken as regular tea or in tablet form.

Replacement of Foley and Pezzer catheter.

In addition to describing the procedure for replacing a catheter, I would like to dwell on a discussion of the current practice of washing catheters and cystostomy drainages at home. You shouldn't do this!!! The need to flush the catheter occurs only in the presence of bleeding or after surgery on the urinary tract, when the catheter can become clogged with blood clots or stone fragments. This usually happens in a hospital. Washing is carried out by the clinic’s medical staff and is done correctly.

At home, washing of catheters and drainages is carried out, as a rule, with the aim of cleaning their internal lumen from plaque and mucus containing a large number of pathogenic bacteria and extending the service life of these same catheters. This does not lead to anything good!!!

As a rule, the development of bacterial resistance to the antiseptics that you use to flush catheters and the lumen of the bladder occurs quite quickly. Therefore, when washing, you wash away the bacterial plaque from the walls of the catheter and drainage tube and drive it into the lumen of the bladder.

If the cystostomy has been in place for quite a long time, more than one month, then the bladder in a significant number of cases is “wrinkled”, i.e. its walls have lost their elasticity and ability to stretch when the bladder is filled with liquid. Therefore, when washing, it is rarely possible to introduce more than 50.0 - 100.0 ml of antiseptic solution into the lumen of the bladder, or pain appears, or fluid begins to leak out in addition to the cystostomy. Does this happen? So, the loss of elasticity of the bladder wall leads to the failure of the mechanism that prevents the reverse flow of urine from the bladder into the ureters and kidneys. What if the urine is infected with bacteria that you washed off the walls of the catheter? Moreover, if the liquid is introduced under pressure, under such good “pressure”? Such washing will sooner or later end with reflux pyelonephritis and urosepsis.

So it doesn’t cost anything to rinse unless absolutely necessary. It is necessary to promptly replace catheters and urinals, i.e. at least once a month, and timely and adequately treat inflammatory processes in the urinary tract and stop bleeding.

As for the catheter replacement procedure itself, replacing a urethral catheter in women is not difficult. I just want to draw attention to the need to treat the external opening of the urethra and vulva with an aqueous solution of an antiseptic, for example, Octenisept, and to use anatomical tweezers and Cathegel or another similar gel with lidocaine and chlorhexedine when inserting a catheter.

When replacing a urethral catheter in men, difficulties may arise, and sometimes very great difficulties. Therefore, ideally, before replacing a Foley catheter, you need to make sure that you have at hand several catheters of different diameters, a metal wire of a suitable diameter, a guide wire, a urethroscope with a urethrotome or a cystoscope with a working channel, etc. To remove a Foley catheter, you need to “deflate” the balloon located at its end in the bladder through a special valve using a syringe. The catheter is removed from the urethra, its external opening is treated with an aqueous solution of an antiseptic, Katedzhel or sterile Vaseline oil is inserted into the urethra, the catheter itself is lubricated with Katedzhel or sterile Vaseline oil and inserted using anatomical tweezers or a “soft” clamp along the urethra into the bladder. 5.0 - 10.0 ml of saline solution is injected into the balloon at the end of the catheter through a special valve using a syringe without a needle. The catheter is “pulled up” and a urinal tube is attached to it.

As for replacing the Foley catheter used as cystostomy drainage, everything happens in the same sequence as described above, just do not forget about the need to treat the skin around the cystostomy fistula with antiseptic solutions, which can be alcohol-containing, and about the need to use for fixation an aseptic bandage applied to the skin of the anterior abdominal wall around the catheter in the form of “pants”, a hypalergenic patch.

In addition, both when replacing a Foley catheter installed as a cystostomy drainage, if less than 1 month has passed since the installation of the cystostomy, and when replacing a Foley catheter installed in the bladder along the urethra, if this doctor changes the catheter for this patient for the first time, I I highly recommend using a string conductor. This will save you from many problems and frustrations.

How to care?

There is no need to remind you once again that panties must be exceptionally clean. Briefs should not compress or deform the catheter.

It is important to ensure that this does not happen during movements. But it is usually not necessary to rinse or reinstall the catheter when inducing labor - its use in obstetrics is disposable

For more information about what a Foley catheter is, see the following video.

medical reviewer, psychosomatics specialist, mother of 4 children

Even more interesting:

Often, a Foley catheter, which is a common medical device in the form of a tube with a balloon, is used to induce labor. Recently, doctors rarely turn to its use, since there are many other, more effective and painless methods.

It is administered exclusively in hospital settings, as it requires professional handling. However, some women in labor find the courage to insert it into the cervix themselves, which is strictly prohibited for reasons of safety, first of all, of the child.

What do those who are going to give birth to a baby with its help need to know about this device?

Medicinal and mixed methods of cervical preparation

After 39 weeks of pregnancy, when the cervix is not “mature” enough, its preparation begins using various methods.

In outpatient practice, antispasmodics are widely used, which reduce the tone of the smooth muscles of internal organs and reduce their contractile activity. They also use instrumental methods for preparing the soft birth canal (acupuncture methods, massage, intranasal electrical stimulation, acupuncture).

In the conditions of the department of pathology of pregnant women of our medical perinatal center, preparation of the cervix is carried out after a complete clinical and laboratory examination of the mother and assessment of the condition of the intrauterine fetus (fetodoplerometry and cardiotocography). Preparation is carried out by introducing kelp, prostaglandins and using synthetic antigestagens.

Natural and artificial kelp is used in obstetrics. Natural kelp is a seaweed that is found in the northern and Far Eastern seas; two types of kelp are used: Laminaria digitata (palmated) and Laminaria japonica (Japanese). Sticks 6–7 cm long and 2–3 mm in diameter are made from specially processed kelp. A strong silk thread is passed through the stick, through which the used dilator is removed. Due to its hygroscopicity, already 3–4 hours after entering the liquid, kelp swells in diameter, reaching a maximum expansion of 3–5 times after 24 hours, and its consistency turns from dense to much softer and resembles rubber. An important positive feature is that, expanding the cervical canal to 9–12 mm, the kelp after swelling remains unchanged in length.

Prostaglandins are highly effective cervical preparation agents. The introduction of prostaglandin E2 leads to both the “ripening” of the cervix and causes contractions of the myometrium as a trigger for the onset of labor. Currently, intracervical administration of Prepedil gel and intravaginal administration of Cervidil gel are used. Mifepristone is a synthetic antigestagen that competes with progesterone at the level of its receptors and removes its inhibitory effect. The use of mifepristone ensures a “mild” process of “ripening” of the cervix, does not cause hyperstimulation of the contractile activity of the uterus and does not have a negative effect on the condition of the fetus and newborn, in most cases leads to complete “ripening” of the cervix, which is the key to spontaneous childbirth with a favorable outcome .

The author of the article is Alexandra Valerievna Shaburova, obstetrician-gynecologist at the Center for Correction of Pregnancy Pathology of the Family Clinic “Maternity Hospital on Furshtatskaya”

Varieties

Foley catheters used during pregnancy differ in material. They can be:

latex - the most comfortable, but can cause an allergic reaction;
silicone - characterized by high biocompatibility, resistance to temperature treatment, salt deposits, and hypoallergenicity;
silicone coated with silver - have antibacterial properties, therefore suitable for long-term catheterization.

There is another classification - according to the type of construction:

Two-way, which are considered classic. Their design provides a common channel and 2 passages, one of which is used to collect urine with a catheter from women during childbirth (the biomaterial can then be sent for analysis in the presence of pregnancy pathologies), and the second is used to fill the balloon with saline solution. This type of product is more expensive.
Three-way ones have an additional channel, which is intended for administering medications to the woman in labor.

To stimulate labor, female devices are used, which are shorter in length, due to which the risk of injury during insertion will be reduced to zero.