Outpatient Induction of Labour

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Outpatient Induction of Labour

  1. 1. Outpatient IOL Philippa Cox
  2. 2. <ul><li>Trialed in 2007 for one year </li></ul><ul><li>Women who are post dates </li></ul><ul><li>Women who have had a low risk pregnancy </li></ul>
  3. 3. Benefits <ul><li>Keeps low risk women out of hospital </li></ul><ul><li>Enables women to stay with their family </li></ul><ul><li>Keeps A/N beds free for women who really need them </li></ul><ul><li>Maintains the message that pregnancy and birth is normal </li></ul>
  4. 4. Audit 2010 (Feb / March) <ul><li>Total IOL = 65 </li></ul><ul><ul><li>Inpatient IOL = 49 </li></ul></ul><ul><ul><li>Outpatient IOL = 16 (of which 2 were admitted before IOL) </li></ul></ul>
  5. 5. Parity
  6. 6. Indication for IOL
  7. 7. Gestation at delivery
  8. 8. Mode of Delivery 8/16 OP 17/49 IP 6/16 OP 24/49 IP 2/16 OP 4/49 IP 4/49 IP
  9. 9. IOL – Delivery Interval <12h 12-24h 24-36h 36-48h >48h OP 25% 25% 25% 25% 0% IP 43% 29% 12% 8% 8%
  10. 10. 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
  11. 11. Maternal Outcome 96% 87.5% 2 PPH >1000ml 1 PPH 1000ml, 1 HTN (d/c PN D7)
  12. 12. Process <ul><li>Community midwives (CMW) offer membrane sweep from 40/41 weeks </li></ul><ul><li>Cmw arranges outpatient IOL, gives IOL leaflet with appointment details </li></ul><ul><li>Woman attends OAU for Ctg and prostin. </li></ul><ul><li>Post prostin and Ctg is NAD goes home with time to return to antenatal ward to continue the process next day. </li></ul>
  13. 13. <ul><li>If spont labour overnight goes to Delivery suite & is assessed. If remains low risk to Birth centre </li></ul><ul><li>Following morning - If requires 2 nd prostin goes to antenatal ward at this point would not go to the birth centre. </li></ul>
  14. 14. Consider <ul><li>Where the OP IOL’s will be undertaken </li></ul><ul><li>Capacity on ward to continue IOL process </li></ul><ul><li>Information leaflets </li></ul><ul><li>Start small then Audit </li></ul>
  15. 15. <ul><li>Any Questions? </li></ul>

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