ObjectiveTo evaluate the feasibility of continuous telemetric trans-abdominal fetal electrocardiogram (a-fECG) in women undergoing labour induction at home.Study DesignLow risk women with singleton term pregnancy undergoing labour induction with retrievable, slow-release dinoprostone pessaries (n = 70) were allowed home for up to 24 hours, while a-fECG and uterine activity were monitored in hospital via wireless technology. Semi-structured diaries were analysed using a combined descriptive and interpretive approach.Results62/70 women (89%) had successful home monitoring; 8 women (11%) were recalled because of signal loss. Home monitoring lasted between 2–22 hours (median 10 hours). Good quality signal was achieved most of the time (86%, SD 10%). 3 women were recalled back to hospital for suspicious a-fECG. In 2 cases suspicious a-fECG persisted, requiring Caesarean section after recall to hospital. 48/51 women who returned the diary coped well (94%); 46/51 were satisfied with home monitoring (90%).ConclusionsContinuous telemetric trans-abdominal fetal ECG monitoring of ambulatory women undergoing labour induction is feasible and acceptable to women.
Assessing the feasibility, acceptability and safety of outpatient labour induction. MEDLINE database was searched for "outpatient labor induction" from January 1, 1986 to February 28, 2013. Main outcomes of interest included hyperstimulation, cesarean births, Apgar scores <7 at 5 minutes, arterial-cord pH of <7.10, and neonatal morbidity/mortality. Overall cesarean rates vary significantly (2.6% to 42%). Hyperstimulation with CTG changes is rare. Neonatal admissions for diverse reasons are often not associated with outpatient induction agent. Overall, maternal satisfaction is high. Outpatient labor induction is feasible and important adverse events are rare. However, paucity of available data and heterogeneity of different studies make it difficult to quantify adverse events or identify a preferred induction method.
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