outpatient foley catheter versus inpatient prostaglandin e2 gel for induction of labour a randomised trial门诊弗利导管与住院病人前列腺素e2凝胶诱导的劳动力一个随机试验.pdfVIP

Henry et al. BMC Pregnancy and Childbirth 2013, 13:25 /1471-2393/13/25 RESEARCH ARTICLE Open Access Outpatient Foley catheter versus inpatient prostaglandin E2 gel for induction of labour: a randomised trial 1,2* 1 1,3 1,3 2 1,2 Amanda Henry , Arushi Madan , Rachel Reid , Sally K Tracy , Kathryn Austin , Alec Welsh and Daniel Challis1,2 Abstract Background: Induction of labour (IOL) is one of the commonest obstetric interventions, with significant impact on both the individual woman and health service delivery. Outpatient IOL is an attractive option to reduce these impacts. To date there is little data comparing outpatient and inpatient IOL methods, and potential safety concerns (hyperstimulation) if prostaglandins, the standard inpatient IOL medications, are used in the outpatient setting. The purpose of this study was to assess feasibility, clinical effectiveness and patient acceptability of outpatient Foley catheter (OPC) vs. inpatient vaginal PGE2 (IP) for induction of labour (IOL) at term. Methods: Women with an unfavourable cervix requiring IOL at term (N = 101) were randomised to outpatient care using Foley catheter (OPC, n = 50) or inpatient care using vaginal PGE2 (IP, n = 51). OPC group had Foley catheter inserted and were discharged overnight following a reassuring cardiotocograph. IP group received 2 mg/1 mg vaginal PGE2 if nulliparous or 1 mg/1 mg if multiparous. Main outcome measures were inpatient stay (prior to birth, in Birthing Unit, total), mode of birth, induction to delivery interval, adverse reactions and patient satisfaction. Results: OPC group had shorter hospital stay prior to birth (21.3 vs. 32.4 hrs, p .001), IP were more likely to achieve vaginal birth wit