Offering women a choice in induction of labour: a prospective cohort study

• Published in: Archives of gynecology and obstetrics Vol. 307; no. 6; pp. 1781 - 1788
• Main Authors: Dupuis, N., Loussert, L., de Vries, P. L. M., Parant, O., Vayssière, C., Guerby, P.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-06-2023; Springer Nature B.V; Springer Verlag
• Subjects: Catheters; Cervical Ripening; Cesarean Section; Cohort analysis; Dinoprostone; Endocrinology; Female; Gynecology; Human Genetics; Human health and pathology; Humans; Induced labor; Labor, Induced - methods; Life Sciences; Maternal-Fetal Medicine; Medicine; Medicine & Public Health; Misoprostol; Obstetrics/Perinatology/Midwifery; Oxytocics; Pregnancy; Prospective Studies; PGE2 pessary; Choice; Misoprostol; Foley catheter; Satisfaction; Induction of labour
• ISSN: 1432-0711; 0932-0067; 1432-0711
• DOI: 10.1007/s00404-022-06652-8

Purpose
To evaluate women’s choice in the method of labour induction between oral misoprostol, PGE2 pessary and the Foley catheter. To compare women’s satisfaction according to their choice and to identify factors associated with patient satisfaction.
Methods
We conducted a comparative, prospective cohort study of 520 women who chose their preferred method for labour induction, in a French tertiary hospital, from July 2019 to October 2020. Before and after the delivery, they were asked to argue their choice and to evaluate their satisfaction through the use of questionnaires. The primary outcome was global level of satisfaction.
Results
Of the 520 women included, 67.5% of women chose oral misoprostol compared to 21% PGE2 pessary and 11.5% Foley catheter. Regarding global satisfaction, we found no significant difference between the three groups: 78.4%, 68.8% and 71.2% (
p
 = 0.107) for, respectively, oral misoprostol, PGE2 pessary and Foley catheter. Factors that seem to improve women’s satisfaction were nulliparity (aOR = 2.03, 95% CI [1.19–3.53]), delivery within 24 h after the start of induction (aOR = 3.46, 95% CI [2.02–6.14]) and adequate information (aOR = 4.21, 95% CI [1.869.64]). Factors associated with lower satisfaction rates were postpartum haemorrhage (aOR = 0.51, 95% CI [0.30–0.88]) and caesarean section (aOR = 0.31, 95% CI [0.17–0.54]).
Conclusion
Women satisfaction rates were not different between the three methods, when chosen by the patients themselves. These finding should encourage caregivers to promote shared decision making when possible.
Trial registration
The protocol was approved by the French ethics committee for research in obstetrics and gynaecology (CEROG, reference number 2019-OBS-0602) on 1st June 2019.