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Re: Still don't agree about that foley!From: RModugno@aol.comSun Aug 27 13:57:23 2000
In a message dated 8/27/00 9:56:58 AM Eastern Daylight Time, wilsonk@gtn.on.ca writes: << Nope. The balloon, correctly placed, is intracervical. Last time I checked, all of our consultants and residents were walking about w/ heads intact, and no evidence of major trauma. Actually women seem not to find the procedure all that uncomfortable. I would guess that that's because the foley balloon would initially elongate to accommodate to the shape of the canal, but places constant pressure on it. Same principle, I would think, as laminaria. >> Do not agree - that balloon should be blown up in the lower uterine segment . Forceful dilatation of the cervix is Painful! The principle is NOT the same as laminaria, which is due to the hygroscopic nature of seaweed, drawing moisture into itself and gradually dilating and therefore not painfully dilating the cervix. As I have mentioned the foley catheter acts by being positioned in the lower uterine segment, thus liftting the membranes off the lower uterine wall and releasing prostaglandins. I thought this was a well-known mechanism which has been known since Embrey's early papers on foley catheter cervical ripening first published in Britain some years ago. Respectfully, Robert Modugno MD MBA FACOG Marietta, GA
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