Introduction Induction of labour (IOL) for postmaturity is recommended between 41+0 and 42+0 weeks. Controlled release prostaglandin-E2 has been used for IOL in an outpatient setting and has been shown to increase maternal satisfaction. Because adverse maternal and fetal outcomes in women being induced for postmaturity are rare, IOL in an outpatient setting should be audited continuously. Low risk women attending for IOL for postmaturity in our unit from March 2011 were offered the option of going home after administration of controlled release prostaglandin-E2 and a normal one hour cardiotocograph.
Method A retrospective audit of 131 inpatients (1.3.10 to 31.8.10) and 140 outpatients (1.3.11 to 31.8.11). All women were between 41+3 and 42+0 weeks with low risk pregnancies at initiation of IOL. All other aspects of the IOL protocol were unchanged and in line with NICE guidance (2008).
Results Eighty five percent of eligible women offered the option chose to go home.
We identified no differences in requirement for additional agents for IOL, mode of birth, or adverse fetal outcome (composite of admission to NICU, apgar <6 at five minutes, umbilical artery pH<7.1). The median time from IOL to birth reduced from 28.1 hours to 25.2 hours.
Conclusion The majority of women choose outpatient IOL if offered the choice and we have demonstrated no clinically significant difference in outcome to date.
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