pro staglandin or ba lloon for induction of labour a t t erm
Download
Skip this Video
Download Presentation
PRO staglandin or BA lloon for induction of labour A t T erm

Loading in 2 Seconds...

play fullscreen
1 / 21

PROstaglandin or BAlloon for induction of labour At Term - PowerPoint PPT Presentation


  • 525 Views
  • Uploaded on

PRO staglandin or BA lloon for induction of labour A t T erm. Researcher: Marta J óź wiak Project leaders: Dr K. Bloemenkamp, Dr J.W. de Leeuw, Dr M.G. van Pampus . Project Group. M. Benthem, UMC Groningen Drs. M.G.K. Dijksterhuis, Ikazia Ziekenhuis Rotterdam

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'PROstaglandin or BAlloon for induction of labour At Term' - kristy


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
pro staglandin or ba lloon for induction of labour a t t erm
PROstaglandin or BAlloon for induction of labour At Term

Researcher: Marta Jóźwiak

Project leaders:

Dr K. Bloemenkamp, Dr J.W. de Leeuw, Dr M.G. van Pampus

project group
Project Group
  • M. Benthem, UMC Groningen
  • Drs. M.G.K. Dijksterhuis, Ikazia Ziekenhuis Rotterdam
  • Dr. J.P.R. Doornbos, Zaans MC
  • Dr. J.W. de Leeuw, Ikazia Ziekenhuis Rotterdam
  • Drs. M. Jozwiak, Ikazia Ziekenhuis Rotterdam
  • Prof. Dr. B.W. Mol, AMC Amsterdam
  • Dr. M.G.van Pampus, UMC Groningen
  • Prof.Dr. J.A.M. van der Post, AMC Amsterdam
  • Dr. K.W.M. Bloemenkamp, LUMC Leiden
content
Content
  • Background
  • Objective
  • In- and exclusion criteria
  • Procedure
  • Outcomes
rationale
Rationale
  • 20-30% of all deliveries are induced
  • 51,000 induced deliveries in The Netherlands annually
  • Method?

NVOG: vaginal prostaglandin gel

PRN 2007, NVOG 2006

current practice
Current Practice

Methods for induction of labour in Dutch

Hospitals 2006

30

26

25

25

20

15

number of hospitals

10

9

10

4

3

5

0

Misoprostol

Vaginal insert

Prostaglandin gel c

Multiple methods

Foley and Prosta

Prostaglandin gel v

Reijers, submitted for publication

slide6
Induction of labour increases assisted delivery and caesarean section rate

LVR 2, Vrouenraets Obstet Gyncol 2005

foley catheter vs prostaglandins
Foley catheter vs prostaglandins
  • Relatively inexpensive method
  • Comparable success rates
  • Comparable/lower caesarean section rate
  • No differences in maternal/neonatal morbidity...

Higher infection rate??

previous studies underpowered

Sciscione AJOG 1999, Ghezzi EJOG 2001,

Boulvain Cochrane 2001, Heinemann AJOG 2008

objective
Objective

To investigate the efficacy and safety of induction of labour with a Foley catheter compared to prostaglandins in term pregnant women with an unfavourable cervix

inclusion criteria
Inclusion criteria
  • Term pregnancy (≥ 37 weeks gestation)
  • Scheduled for induction of labour
  • Vital singleton pregnancy
  • Intact membranes
  • Cephalic presentation
  • Unfavourable cervix (Bishop score <6)
exclusion criteria
Exclusion criteria
  • History of caesarean section (separate study!)
  • Placenta praevia
  • Fetal anomalies
  • Contraindication for use of one of the products used for induction of labour
randomisation procedure
Randomisation procedure

Inform patient when scheduled for induction, patient information leaflet

Day of induction

  • CTG
  • Bishop Score
  • Informed consent
  • Randomisation
randomisation
Randomisation
  • Transcervical Foley catheter
  • Prostaglandins according to local protocol
slide15
If after 24 hours the cervix is unfavourable for amniotomy

 another 24 hours of induction

  • If after second 24 hours the cervix is unfavourable for amniotomy

 day of rest, followed by a maximum of another 48 hours of induction

NO CROSS-OVER!!!

outcome
Outcome

Primary outcome

  • Caesarean section rate

Secondary outcome

  • Assisted delivery rate
  • Induction to delivery interval
  • Neonatal morbidity
    • Apgar Score ≤ 6 after 1 and 5 minutes
    • Umbilical cord pH ≤ 7.10
    • Admission due to suspected infection
    • Other admissions
outcome17
Outcome

Maternal morbidity

  • Hyperstimulation
  • Maternal infection
  • Post partum haemorrhage

Cost analysis

sample size
Sample size

Reduction of caesarean section rate from 25% to 17%

406 patients in each group (α 0.05, power 80%)

hospitals
Hospitals

AMC Amsterdam

Spaarne Hoofddorp

Zaans MC Zaandam

Tweesteden Tilburg

Máxima MC Veldhoven

Jeroen Bosch s-Hertogenbosch

Elkerliek Helmond

UMCG Groningen

MC Leeuwarden Leeuwarden

LUMC Leiden

Groene Hart Gouda

MCH Westeinde Den Haag

HAGA ziekenhuis Den Haag

MUMC Maastricht

Amphia Breda

Ikazia Rotterdam

St Antonius Nieuwegein

Diakonessen Utrecht

Meander MC Amersfoort

contact information
Contact information

www.studies-obsgyn.nl/probaat

[email protected]

Marta Jóźwiak

Arts-onderzoeker PROBAAT

ad