Outpatient Induction of Labour
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Outpatient Induction of Labour

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    Outpatient Induction of Labour Outpatient Induction of Labour Presentation Transcript

    • Outpatient IOL Philippa Cox
      • Trialed in 2007 for one year
      • Women who are post dates
      • Women who have had a low risk pregnancy
    • Benefits
      • Keeps low risk women out of hospital
      • Enables women to stay with their family
      • Keeps A/N beds free for women who really need them
      • Maintains the message that pregnancy and birth is normal
    • Audit 2010 (Feb / March)
      • Total IOL = 65
        • Inpatient IOL = 49
        • Outpatient IOL = 16 (of which 2 were admitted before IOL)
    • Parity
    • Indication for IOL
    • Gestation at delivery
    • Mode of Delivery 8/16 OP 17/49 IP 6/16 OP 24/49 IP 2/16 OP 4/49 IP 4/49 IP
    • IOL – Delivery Interval <12h 12-24h 24-36h 36-48h >48h OP 25% 25% 25% 25% 0% IP 43% 29% 12% 8% 8%
    • Fetal Outcome 94% 98% 1 low apgars 2,9,10, observed in SCBU 1 RDS & neonatal sepsis, admitted to SCBU for Abx and breathing support Note ; 2 other admissions to SCBU for observation from IP group, no complications
    • Maternal Outcome 96% 87.5% 2 PPH >1000ml 1 PPH 1000ml, 1 HTN (d/c PN D7)
    • Process
      • Community midwives (CMW) offer membrane sweep from 40/41 weeks
      • Cmw arranges outpatient IOL, gives IOL leaflet with appointment details
      • Woman attends OAU for Ctg and prostin.
      • Post prostin and Ctg is NAD goes home with time to return to antenatal ward to continue the process next day.
      • If spont labour overnight goes to Delivery suite & is assessed. If remains low risk to Birth centre
      • Following morning - If requires 2 nd prostin goes to antenatal ward at this point would not go to the birth centre.
    • Consider
      • Where the OP IOL’s will be undertaken
      • Capacity on ward to continue IOL process
      • Information leaflets
      • Start small then Audit
      • Any Questions?