Fride E. Austad, Jörg Kessler, Elisabeth Balstad Magnussen, Are Hugo Pripp, Janne Rossen
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引用次数: 0
Abstract
Objective
To compare childbirth satisfaction and obstetrical outcomes with outpatient versus inpatient induction of labour (IOL).
Design
Multicentre, randomised-controlled trial.
Setting
Eight hospitals in Norway.
Population
Women scheduled for IOL, single cephalic presentation, ≥ 37 weeks, no previous uterine scar, and low risk of complications by predefined criteria.
Methods
Included women received oral misoprostol (25 μg) for up to 48 h as the primary induction agent. The Childbirth Experience Questionnaire (CEQ) and the Experience with Induction Tool (EXIT) were used to assess childbirth satisfaction.
Main Outcome Measures
CEQ-score.
Secondary Outcome Measures
EXIT questionnaire and obstetrical outcomes.
Results
Of 283 women randomised, 152 women were allocated to outpatient and 131 to inpatient settings. Outpatient IOL resulted in a more positive childbirth experience (mean CEQ-score 3.1 [0.44] vs. 3.0 [0.45]), mean difference 0.14, 95% CI (0.02–0.25), p = 0.02. In the outpatient group, women were admitted to the hospital 21 h shorter before delivery (15 vs. 36 h, mean difference −21, 95% CI −25 to −17, p < 0.01). Obstetrical outcomes were similar, and there were no cases of hyperstimulation before labour or serious adverse events.
Conclusion
Outpatient IOL using oral misoprostol was associated with high maternal satisfaction, with 89% of women expressing a preference for this method in future pregnancies. Labour outcomes appear comparable to those of inpatient induction, while outpatient management also provides potential cost benefits due to shorter hospital admission. We advocate for this method as a feasible option for appropriately selected women; however, the occurrence of rare adverse events necessitates further investigation through larger studies.
Trial Registration
ID NCT05144048. https://clinicaltrials.gov/study/NCT05144048?locStr=Norway&country=Norway&cond=Induction%20of%20Labor&rank=1
期刊介绍：
BJOG is an editorially independent publication owned by the Royal College of Obstetricians and Gynaecologists (RCOG). The Journal publishes original, peer-reviewed work in all areas of obstetrics and gynaecology, including contraception, urogynaecology, fertility, oncology and clinical practice. Its aim is to publish the highest quality medical research in women''s health, worldwide.
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