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Offering women a choice in induction of labour in case of an unfavorable cervix: a prospective cohort study
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  • Ninon Dupuis,
  • Lola Loussert,
  • Pauline de Vries,
  • Olivier Parant,
  • Christophe Vayssiere,
  • Paul Guerby
Ninon Dupuis
CHU Toulouse
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Lola Loussert
CHU Toulouse
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Pauline de Vries
Leiden University Medical Center
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Olivier Parant
CHU Toulouse
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Christophe Vayssiere
CHU Toulouse
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Paul Guerby
CHU Toulouse
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Abstract

Objective: 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. Design: Prospective cohort study. Setting: Tertiary hospital in Toulouse, France, from July 2019 to October 2020. Population: All women admitted for labour induction at term, by either oral misoprostol, PGE2 pessary or Foley catheter. Methods: Women chose their preferred method. Before and after the delivery, they were asked to argument their choice and to evaluate their satisfaction through the use of questionnaires. Main outcome measures: 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% the Foley catheter. Regarding global satisfaction, we found no significant difference between the three groups: 78,4%, 68,8% and 71,2% (p=0,091) for respectively oral misoprostol, PGE2 pessary and Foley catheter. Factors that seem to improve women’s satisfaction were nulliparity (OR = 2.03, 95%CI [1.19 - 3.53]), delivery within 24 hours after the start of induction (OR = 3.46, 95%CI. [2.02 - 6.14]) and adequate information (OR = 4.21,95%CI [1.86 - 9.64]). Factors associated with lower satisfaction rates were postpartum hemorrhage (OR = 0.51, 95%CI [0.30 - 0.88]) and caesarean section (OR = 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.

Peer review status:UNDER REVIEW

26 May 2021Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
28 May 2021Assigned to Editor
28 May 2021Submission Checks Completed
01 Jun 2021Reviewer(s) Assigned