Optimising daytime deliveries when inducing labour using prostaglandin vaginal inserts

Hugh Miller, Laura Goetzl, Deborah A Wing, Barbara Powers, Olof Rugarn, Hugh Miller, Laura Goetzl, Deborah A Wing, Barbara Powers, Olof Rugarn

Abstract

Objective: To determine induction start time(s) that would maximise daytime deliveries when using prostaglandin vaginal inserts.

Methods: Women enrolled into the Phase III trial, EXPEDITE (clinical trial registration: NCT01127581), had labour induced with either a misoprostol or dinoprostone vaginal insert (MVI or DVI). A secondary analysis was conducted to determine the optimal start times for induction by identifying the 12-h period with the highest proportion of deliveries by parity and treatment.

Results: Optimal start times for achieving daytime deliveries when using MVI appear to be 19:00 in nulliparae and 23:00 in multiparae. Applying these start times, the median time of onset of active labour would be approximately 08:30 for both parities and the median time of delivery would be the following day at approximately 16:30 for nulliparae and 12:00 (midday) for multiparae. Optimal start times when using DVI appear to be 07:00 for nulliparae and 23:00 for multiparae. Using these start times, the median time of onset of active labour would be the following day at approximately 04:00 and 11:50, and the median time of delivery would be approximately 13:40 and 16:10, respectively.

Conclusions: When optimising daytime deliveries, different times to initiate induction of labour may be appropriate depending on parity and the type of retrievable prostaglandin vaginal insert used.

Keywords: Daytime deliveries; dinoprostone; induction of labour; misoprostol; retrievable prostaglandin vaginal delivery systems.

Figures

Figure 1.
Figure 1.
Intervals from MVI insertion to delivery using optimised start times. MVI, misoprostol vaginal insert.
Figure 2.
Figure 2.
Intervals from DVI insertion to delivery using optimised start times. DVI, dinoprostone vaginal insert.

References

    1. Paccaud F, Martin-Beran B, Gutzwiller F. Hour of birth as a prognostic factor for perinatal death. Lancet. 1988;1:340–3.
    1. Stewart JH, Andrews J, Cartlidge PH. Numbers of deaths related to intrapartum asphyxia and timing of birth in all Wales perinatal survey, 1993–5. BMJ. 1998;316:657–60.
    1. Chalmers JW, Shanks E, Paterson S, et al. Scottish data on intrapartum related deaths are in same direction as Welsh data. BMJ. 1998;317:539–40.
    1. Stephansson O, Dickman PW, Johansson AL, et al. Time of birth and risk of intrapartum and early neonatal death. Epidemiology. 2003;14:218–22.
    1. Gould JB, Qin C, Chavez G. Time of birth and the risk of neonatal death. Obstet Gynecol. 2005;106:352–8.
    1. Badr LK, Abdallah B, Balian S, et al. The chasm in neonatal outcomes in relation to time of birth in Lebanon. Neonatal Netw. 2007;26:97–102.
    1. Gijsen R, Hukkelhoven CW, Schipper CM, et al. Effects of hospital delivery during off-hours on perinatal outcome in several subgroups: a retrospective cohort study. BMC Pregn Childbirth. 2012;12:92.
    1. Kalogiannidis I, Margioula-Siarkou C, Petousis S, et al. Infant births during the internal night are at increased risk for operative delivery and NICU admission. Arch Gynecol Obstet. 2011;284:65–71.
    1. Heller G, Misselwitz B, Schmidt S. Early neonatal mortality, asphyxia related deaths, and timing of low risk births in Hesse, Germany, 1990–8: observational study. BMJ. 2000;321:274–5.
    1. Luo ZC, Karlberg J. Timing of birth and infant and early neonatal mortality in Sweden 1973–95: longitudinal birth register study. BMJ. 2001;323:1327–30.
    1. de Cordova PB, Phibbs CS, Bartel AP, Stone PW. Twenty-four/seven: a mixed-method systematic review of the off-shift literature. J Adv Nurs. 2012;68:1454–68.
    1. de Cordova PB, Phibbs CS, Stone PW. Perceptions and observations of off-shift nursing. J Nurs Manag. 2013;21:283–92.
    1. Gaba DM, Howard SK. Patient safety: fatigue among clinicians and the safety of patients. N Engl J Med. 2002;347:1249–55.
    1. Jagsi R, Kitch BT, Weinstein DF, et al. Residents report on adverse events and their causes. Arch Intern Med. 2005;165:2607–13.
    1. Caughey AB, Urato AC, Lee KA, et al. Time of delivery and neonatal morbidity and mortality. Am J Obstet Gynecol. 2008;199:496 e1–5.
    1. Bakker JJ, van der Goes BY, Pel M, et al. Morning versus evening induction of labour for improving outcomes. Cochrane Database Syst Rev. 2013;2:CD007707.
    1. Wing DA, Brown R, Plante LA, et al. Misoprostol vaginal insert and time to vaginal delivery: a randomized controlled trial. Obstet Gynecol. 2013;122:201–9.
    1. Fraser WD, McLean FH, Usher RH. Diurnal variation in admission to hospital of women in labour. Can J Surg. 1989;32:33–5.
    1. Cagnacci A, Soldani R, Melis GB, Volpe A. Diurnal rhythms of labor and delivery in women: modulation by parity and seasons. Am J Obstet Gynecol. 1998;178:140–5.
    1. Anderka M, Declercq ER, Smith W. A time to be born. Am J Public Health. 2000;90:124–6.
    1. American College of Obstetricians Gynecologists; Society for Maternal-Fetal Medicine Obstetric care consensus no. 1: safe prevention of the primary cesarean delivery. Obstet Gynecol. 2014;123:693–711.
    1. National Institute for Health and Care Excellence. NICE guidelines [CG70] Induction of labour. Available from: [last accessed 20 Dec 2014]
    1. Dodd JM, Crowther CA, Robinson JS. Morning compared with evening induction of labor: a nested randomized controlled trial. A nested randomized controlled trial. Obstet Gynecol. 2006;108:350–60.
    1. Bakker JJ, De Vos R, Pel M, et al. Start of induction of labour with oxytocin in the morning or in the evening. A randomised controlled trial. BJOG. 2009;116:562–8.
    1. Oei SG, Jongmans L, Mol BW. Randomized trial of administration of prostaglandin E2 gel for induction of labor in the morning or the evening. J Perinat Med. 2000;28:20–5.
    1. Thorsell M, Lyrenas S, Andolf E, Kaijser M. Starting time for induction of labor and the risk for night-time delivery. Sex Reprod Healthc. 2011;2:113–17.

Source: PubMed

Спонсоры и соавторы

Заболевания

Медикаментозные вмешательства

Подписаться