8 am versus 8 pm labour induction with dinoprostone vaginal tablets in term pregnancies with unfavourable cervices—a randomised controlled trial

Abstract

8 am versus 8 pm labour induction with dinoprostone vaginal tablets in term pregnancies with unfavourable cervices—a randomised controlled trial Aizura Syafinaz Ahmad Adlan1, *, Vikneswaran Virasamy1 , Doris Ng Sin-Wen2 , Noor Azmi Mat Adenan1 1Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia 2Department of Obstetrics and Gynaecology, University Malaya Medical Centre, 59100 Kuala Lumpur, Malaysia *Correspondence: syafinaz@ummc.edu.my (Aizura Syafinaz Ahmad Adlan) DOI:10.31083/j.ceog.2021.03.2337 This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/). Submitted: 27 October 2020 Revised: 14 January 2021 Accepted: 26 February 2021 Published: 15 June 2021 Background: To evaluate the feasibility of timing delivery of induction of labour cases to occur during oȞfice hours and reduce night time delivery. Methods: Patients scheduled for induction of labour were randomized to 8 am or 8 pm insertion of dinoprostone vaginal tablets. The main outcome measure was time of delivery between 8 am to 5 pm. The secondary outcome measures were mode of delivery and its indications, neonatal outcomes, maternal satisfaction and labour room staȞf satisfaction. Results: 164 patients were recruited with 78 patients randomized to the 8 am group and 86 patients randomized to the 8 pm group. There was no significant diȞference in timing of delivery between both groups, with delivery between 8 am to 5 pm for the 8 am group being 35.9% and for the 8 pm group being 44.2% (P = 0.339). For the secondary outcome measures, there was no significant diȞference found between mode of delivery (vaginal, instrumental or Caesarean section), neonatal Apgar score and cord blood pH, nor maternal satisfaction score based on the Likert scale. However there was a statistically significant diȞference (P = 0.001) for labour ward staȞf satisfaction based on the Likert scale, favouring the 8 pm induction timing. Conclusion: 8 am versus 8 pm timing for induction of labour has no significant diȞference to the timing of delivery during oȞfice hours, but the 8 pm induction of labour group has significantly greater labour ward staȞf satisfaction. Keywords Induction of labour; Randomized trial; Timing of delivery; StaȞf satisfaction