Home versus inpatient induction of labour for improving birth outcomes

Alfirević, Z̄arko; Gyte, Gillian ML; Pileggi, Vicky Nogueira; Plachcinski, Rachel; Osoti, Alfred; Finucane, Elaine

doi:10.1002/14651858.cd007372.pub4

Cited by 21 publications

(39 citation statements)

References 44 publications

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“…However, because of the small number of women, the bias is presumably marginal. According to the latest Cochrane review on the issue, 12 women’s experiences of OP vs IP IOL are limited, and validation of the questionnaires is not comprehensive. However, as in other induction studies, we used VAS questionnaires with similar items 10,14,16,17,21,28‐30 .…”

Section: Discussionmentioning

confidence: 99%

“…As for the low risk of uterine hyperstimulation, 4,6,8 the WHO also prefers catheter induction when the uterus is scarred. Furthermore, the evidence to date suggests that for low‐risk pregnancies, IOL with a catheter is safe for use even in an OP setting 9‐12 . However, there is only a limited amount of data regarding women’s experiences of IOL with a catheter 6,12 .…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, the evidence to date suggests that for low‐risk pregnancies, IOL with a catheter is safe for use even in an OP setting 9‐12 . However, there is only a limited amount of data regarding women’s experiences of IOL with a catheter 6,12 . Most of the previous studies on IOL have compared catheter induction with prostaglandin (PGE) and with a variety of settings 6,13 .…”

Section: Introductionmentioning

confidence: 99%

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Experiences of induction of labor with a catheter – A prospective randomized controlled trial comparing the outpatient and inpatient setting

Haavisto

Polo‐Kantola

Anttila

et al. 2020

Acta Obstet Gynecol Scand

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Introduction Approximately every fourth labor is induced. In Finland, when labor is induced, it is commonly carried out with a catheter in the inpatient (IP) setting. However, in uncomplicated, full‐term pregnancies, induction of labor (IOL) in the outpatient (OP) setting is also possible. Nevertheless, there is only a limited amount of information about the experiences of IOL in OP setting. Our study compared the experiences of catheter IOL in OP and IP settings. Material and methods We performed a prospective randomized study, including 113 women with uncomplicated full‐term pregnancies with planned IOL. After catheter insertion, women were randomized into OP or IP settings: after dropouts, there were 53 women in the OP group and 54 in the IP. The experiences of IOL were evaluated with three sets of visual analog scale (VAS) questionnaires: the general experience questionnaire (eight questions), the concurrent induction experience questionnaire (1, 5, 9, 13 hours; nine questions) and the postpartum experience questionnaire (14 questions). Results Both groups had low VAS scores, indicating good experiences of IOL. Women in the OP group were less satisfied (mean VAS difference Δ = 7.8, P = .015) and more anxious (Δ = 4.8, P = .008) than were women in the IP group. In the course of the IOL, all women became less satisfied (Δ = 8.4, P = .001), had more contraction pain (Δ = 8.9, P = .020) and had a higher frequency of contractions (Δ = 9.9, P = .004) but they were more relaxed and experienced less fear (Δ = 6.9, P = .036, Δ = 5.3, P = .001, respectively). There was no interaction between group and time. According to the postpartum experience questionnaire, both groups had a similar good general experience of IOL (P = .736) but the OP group had more fear (Δ = 9.5, P = .009) and was more anxious (Δ = 9.0, P = .007). Most of the women would choose catheter IOL in a subsequent pregnancy (OP 82.6%, IP 87.0%). Conclusions The women in the OP setting were less satisfied and more anxious than were the women in the IP setting. However, the differences were marginal and the general experience after IOL was good. IOL in an OP setting is thus a viable option in low‐risk full‐term pregnancies. Therefore, when using catheter IOL, both setting options should be available.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Experiences of induction of labor with a catheter – A prospective randomized controlled trial comparing the outpatient and inpatient setting

Haavisto

Polo‐Kantola

Anttila

et al. 2020

Acta Obstet Gynecol Scand

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“…Medical indications for induction of labour include preterm premature rupture of membranes (PPROM), intrauterine growth restriction, hypertensive disorders of pregnancy, intrauterine foetal death and post-term pregnancies [6]. Of these, post-term pregnancy is the most common [7,8].…”

Section: Introductionmentioning

confidence: 99%

Feasibility study protocol of a pragmatic, randomised controlled pilot trial: membrane sweeping to prevent post-term pregnancy—the MILO Study

Finucane

Murphy

Cotter

et al. 2021

Trials

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Background Post-term pregnancy is associated with an increased risk of maternal complications, respiratory distress and trauma to the neonate. Amniotic membrane sweeping has been recommended as a simple procedure to promote the spontaneous onset of labour. However, despite its widespread use, there is an absence of evidence on (a) its effectiveness and (b) its optimal timing and frequency. The primary aim of the MILO Study is to inform the optimal design of a future definitive randomised trial to evaluate the effectiveness (including optimal timing and frequency) of membrane sweeping to prevent post-term pregnancy. We will also assess the acceptability and feasibility of the proposed trial interventions to clinicians and women (through focus group interviews). Methods/design Multicentre, pragmatic, parallel-group, pilot randomised controlled trial with an embedded factorial design. Pregnant women with a live, singleton foetus ≥ 38 weeks gestation; cephalic presentation; longitudinal lie; intact membranes; English speaking and ≥ 18 years of age will be randomised in a 2:1 ratio to membrane sweep versus no membrane sweep. Women allocated randomly to a sweep will then be randomised further (factorial component) to early (from 39 weeks) versus late (from 40 weeks) sweep commencement and a single versus weekly sweep. The proposed feasibility study consists of four work packages, i.e. (1) a multicentre, pilot randomised trial; (2) a health economic analysis; (3) a qualitative study; and (4) a study within the host trial (a SWAT). Outcomes to be collected include recruitment and retention rates, compliance with protocol, randomisation and allocation processes, attrition rates and cost-effectiveness. Focus groups will be held with women and clinicians to explore the acceptability and feasibility of the proposed intervention, study procedures and perceived barriers and enablers to recruitment. Discussion The primary aim of the MILO Study is to inform the optimal design of a future definitive randomised trial to evaluate the effectiveness (including optimal timing and frequency) of membrane sweeping to prevent post-term pregnancy. Results will inform whether and how the design of the definitive trial as originally envisaged should be delivered or adapted. Trial registration ClinicalTrials.gov NCT04307199. Registered on 12 March 2020

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“…Medical indications for an induction of labour include preterm premature rupture of membranes (PPROM), intra uterine growth restriction, hypertensive disorders of pregnancy, intra-uterine fetal death and post-term pregnancies [8]. Of these, post-term pregnancy is the most common [9,10].…”

mentioning

confidence: 99%

Feasibility study protocol of a pragmatic, randomised controlled pilot trial: Membrane sweeping to prevent post-term pregnancy: The MILO Study

Finucane

Murphy

Cotter

et al. 2021

Preprint

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Background Post-term pregnancy is associated with an increased risk of maternal complications, respiratory distress and trauma to the neonate. Amniotic membrane sweeping has been recommended as a simple procedure to promote the spontaneous onset of labour. However, despite its widespread use, there is an absence of evidence on a) its effectiveness and b) its optimal timing and frequency. The primary aim of the MILO study is to inform the optimal design of a future definitive randomised trial to evaluate the effectiveness (including optimal timing and frequency) of membrane sweeping to prevent post-term pregnancy. We will also assess the acceptability and feasibility of the proposed trial interventions to clinicians and women (through focus group interviews).Methods/Design Multicentre, pragmatic, parallel group, pilot randomised controlled trial with an embedded factorial design. Pregnant women with a live, singleton fetus ≥ 38 weeks gestation, cephalic presentation, longitudinal lie, intact membranes, English speaking and ≥18 years of age will be randomised in a 2:1 ratio to:Membrane sweep versus no membrane sweep Women allocated randomly to a sweep will then be randomised further (factorial component) to:early (from 39 weeks) versus late (from 40 weeks) sweep commencement; and a single verses weekly sweep The proposed feasibility study consists of four work packages i.e., (1) a multicentre, pilot randomised trial, 2) a health economic analysis and 3) a qualitative study (4) a study within the host trial (a SWAT). Outcomes to be collected include: recruitment and retention rates, compliance with protocol, randomisation and allocation processes, attrition rates and cost-effectiveness. Focus groups will be held with women and clinicians to explore the acceptability and feasibility of the proposed intervention, study procedures and perceived barriers and enablers to recruitment.Discussion The primary aim of the MILO study is to inform the optimal design of a future definitive randomised trial to evaluate the effectiveness (including optimal timing and frequency) of membrane sweeping to prevent post-term pregnancy. Results will inform whether and how the design of the definitive trial as originally envisaged should be delivered or adapted.Trial Registration ClinicalTrials.gov, ID: NCT04307199. Registered 12th March 2020. https://clinicaltrials.gov/ct2/show/NCT04307199?id=NCT04307199&draw=2&rank=1

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Home versus inpatient induction of labour for improving birth outcomes

Abstract: Home versus inpatient induction of labour for improving birth outcomes.

Cited by 21 publications

References 44 publications

Experiences of induction of labor with a catheter – A prospective randomized controlled trial comparing the outpatient and inpatient setting

Experiences of induction of labor with a catheter – A prospective randomized controlled trial comparing the outpatient and inpatient setting

Feasibility study protocol of a pragmatic, randomised controlled pilot trial: membrane sweeping to prevent post-term pregnancy—the MILO Study

Feasibility study protocol of a pragmatic, randomised controlled pilot trial: Membrane sweeping to prevent post-term pregnancy: The MILO Study

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