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Outpatient Foley For Starting Induction of Labor at TErm

Outpatient Foley for Starting Induction of Labor at Term

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02756689
Acronym
OFFSITE
Enrollment
129
Registered
2016-04-29
Start date
2016-03-31
Completion date
2017-10-31
Last updated
2019-07-09

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Pregnancy

Keywords

Mechanical cervical ripening, Transcervical catheter, Foley catheter for labor induction, Cervical ripening, Induction of labor

Brief summary

The investigators are performing a randomized controlled-trial investigating starting cervical ripening in the outpatient setting with a mechanical method, the transcervical Foley catheter. This is a pilot study to establish the efficacy of this method in decreasing time as in inpatient and evaluate patient satisfaction.

Detailed description

Induction of labor is necessary in one-fourth of women and a large proportion requires cervical ripening. Cervical ripening is necessary to shorten the time to delivery and increases the chances of a vaginal delivery. Outpatient cervical ripening is an attractive alternative to women and physicians because of the decreased amount of time spent in the hospital and opportunity for patients to be in the comforts of their home. The investigators will conduct a randomized controlled trial comparing outpatient to inpatient cervical ripening using a transcervical Foley catheter. Women will be randomized to undergo inpatient or outpatient transcervical Foley catheter cervical ripening beyond their 39th week of gestation. Women and their infants will be followed until the time of their discharge.

Interventions

Subjects will undergo cervical ripening in the inpatient setting.

Subjects will undergo cervical ripening in the outpatient setting. The patients will then be scheduled to return the next morning for induction of labor.

Sponsors

University of Alabama at Birmingham
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Age ≥18 * Multiparous * Singleton gestation * Gestational age between 39+0 and 42+0 * Vertex presentation * Cervix ≤ 3 cm. If cervix is between 2 and 3 cm dilated, it must be \<80% effaced * No prior cesarean section or uterine surgery * Resides within Jefferson County, Alabama. * Access to a telephone * Reliable transportation

Exclusion criteria

* Unsuitable for outpatient Foley placement management (IUGR, oligohydramnios, prior cesarean delivery, gestational hypertension, preeclampsia, or uncontrolled chronic hypertension, complex maternal disease, provider discretion). Any patient with pregestational or gestational diabetes on medications will be excluded. * Latex allergy * Contraindication to induction of labor * Evidence of labor * Fetal anomaly or demise * Inability to given consent (non-English speaking, inability to read or write)

Design outcomes

Primary

MeasureTime frame
Total Time From Admission to DeliveryFrom baseline to the time of delivery (baseline is from admission), up to 7 days

Secondary

MeasureTime frameDescription
Highest Maternal Intrapartum TemperatureAssessed from baseline to delivery, up to 3 days
Number of Participants With ChorioamnionitisAssessed from baseline to delivery.
Number of Participants With Meconium-stained FluidAssessed from baseline to delivery.
Number of Participants With Neonates With Shoulder DystociaAssessed at delivery.
Nonreassuring Fetal Heart Tracings 30-minutes After Foley Bulb Placement.From placement until 30 minutes.
Total Duration of Time of Neuraxial Anesthesia UseAssessed from baseline to delivery, up to 3 days
Total Duration of Time From Rupture of Membranes Until DeliveryAssessed from baseline to delivery, up to 3 days
Total Hospital DurationFrom admission time to the hospital until discharge from the hospital, up to 7 days
Number of Participants Using AcetaminophenFrom placement of Foley bulb to 24 hours.
Number of Participants Calling the Obstetrical Triage UnitFrom placement of Foley bulb to 24 hours.
Number of Participants Admitted Prior to the Scheduled Induction of Labor TimeFrom placement of Foley bulb to 24 hours.
Number of Participants With Spontaneous Rupture of Membranes Between Foley Bulb Placement and AdmissionFrom placement of Foley bulb to 24 hours.
Number of Participants Who Had a Cesarean DeliveryAssessed from baseline to delivery.
Number of Participants With an Operative Vaginal DeliveryAssessed at delivery.
Postpartum HemorrhageAssessed at delivery.
Number of Participants With EndometritisAssessed from delivery until 30 days post-discharge.
Number of Participants With Readmission Within 30 DaysAssessed from time of discharge until 30 days post-discharge.
Number of Neonates With a 5-minute Apgar Score Less Than 7Assessed at time of delivery up to 5-minutes post-delivery.Apgar scores are assigned to all births. These are universally performed and assigned in the United States. The scoring system is between 0-10. 0 is the minimum score and 10 is the maximum. Lower scores are worse than higher scores.
Number of Neonates With Umbilical Artery Cord pH < 7.1Assessed at time of delivery up to 5-minutes post-delivery.
Number of Neonates With an Umbilical Cord Artery Base Deficit Less Than Negative 12Assessed at time of delivery up to 5-minutes post-delivery.Base deficit is a lab value.
Number of Neonates With Birth InjuriesAssessed at time of delivery up to time of neonatal discharge, up to 30 days.Cephalohematomas, subgaleal hematomas, fracture of the clavicle, and scalp lacerations
Number of Neonates Admitted to the Neonatal Intensive Care Unit AdmissionsAssessed at time of delivery up to time of neonatal discharge, up to 30-daysThe rates of neonatal intensive care unit admissions will be calculated.
Patient Satisfaction Six Simple Questions, Q1At discharge.Assessed through validated survey, Six Simple Questions. Adapted from Harvey S, Rach D, et al. Evaluation of satisfaction with midwifery care. 2002 Dec; 18(4):260-7. 1=strongly agree, 4 = neutral, 7=strongly agree. Title: Six simple questions Definition: A survey to assess patient satisfaction during their cervical ripening and induction. Ranges: 1-7 Best score: 7 Worst score: 1
Patient Satisfaction (Six Simple Questions, Question 2)At dischargeAssessed through validated survey (Six simple questions, Q-2). Question 2: The person(s) responsible for my care are/were caring and compassionate. Scale 1-7. 1=strongly agree, 4 = neutral, 7=strongly agree. Title: Six simple questions Definition: A survey to assess patient satisfaction during their cervical ripening and induction. Ranges: 1-7 Best score: 7 Worst score: 1
Patient Satisfaction (Six Simple Questions, Question 3)At dischargeAssessed through validated survey, Six Simple Questions. Adapted from Harvey S, Rach D, et al. Evaluation of satisfaction with midwifery care. 2002 Dec; 18(4):260-7. Question 3: Problems that have arisen up to now have not been dealt with effectively. Scale 1-7. 1=strongly agree, 4 = neutral, 7=strongly agree. Title: Six simple questions Definition: A survey to assess patient satisfaction during their cervical ripening and induction. Ranges: 1-7 Best score: 7 Worst score: 1
Patient Satisfaction (Six Simple Questions, Question 4)At dischargeAssessed through validated survey, Six Simple Questions. Adapted from Harvey S, Rach D, et al. Evaluation of satisfaction with midwifery care. 2002 Dec; 18(4):260-7. Question 4: My needs have been addressed with appropriate consideration for my time. Scale 1-7. 1=strongly agree, 4 = neutral, 7=strongly agree. Title: Six simple questions Definition: A survey to assess patient satisfaction during their cervical ripening and induction. Ranges: 1-7 Best score: 7 Worst score: 1
Patient Satisfaction (Six Simple Questions, Question 5)At dischargeAssessed through validated survey, Six Simple Questions. Adapted from Harvey S, Rach D, et al. Evaluation of satisfaction with midwifery care. 2002 Dec; 18(4):260-7. Question 5: The overall organization of my ca re has not been appropiate. Scale 1-7. 1=strongly agree, 4 = neutral, 7=strongly agree. Title: Six simple questions Definition: A survey to assess patient satisfaction during their cervical ripening and induction. Ranges: 1-7 Best score: 7 Worst score: 1
Patient Satisfaction (Six Simple Questions, Question 6)At dischargeAssessed through validated survey, Six Simple Questions. Adapted from Harvey S, Rach D, et al. Evaluation of satisfaction with midwifery care. 2002 Dec; 18(4):260-7. Question 6: I would choose the same type of care for my next pregnancy. Scale 1-7. 1=strongly agree, 4 = neutral, 7=strongly agree. Title: Six simple questions Definition: A survey to assess patient satisfaction during their cervical ripening and induction. Ranges: 1-7 Best score: 7 Worst score: 1
Patient Satisfaction (Lady-X Survey, Question 1)At dischargeAssessed through a validated survey, Lady-X. Adapted from Gartner FR, de Bekker-Grob EW et al. Calculating preference weights for the labor and delivery index: A discrete choice experiment on women's birth experiences. Value Health. 2015 Sep; 856-864. Question 1: Presence of healthcare professionals during my birth. Scale 1-3. 1 = At all times, 2 = Most of the time, 3 = rarely Title: Lady-X Survey Definition: A survey to assess patient satisfaction and experience during their cervical ripening and induction. Ranges: 1-3 Best score: 1 Worst score: 3
Patient Satisfaction (Lady-X Survey, Question 2)At dischargeAssessed through a validated survey, Lady-X Survey. Adapted from Gartner FR, de Bekker-Grob EW et al. Calculating preference weights for the labor and delivery index: A discrete choice experiment on women's birth experiences. Value Health. 2015 Sep; 856-864. Question 2: Information given by the healthcare professionals during childbirth. Scale 1-3. 1 = I felt very well informed by the healthcare professionals, 2 = I felt adequately informed by the healthcare professionals, 3 = I felt inadequately informed by the healthcare professionals. Title: Lady-X Survey Definition: A survey to assess patient satisfaction and experience during their cervical ripening and induction. Ranges: 1-3 Best score: 1 Worst score: 3
Patient Satisfaction (Lady-X Survey, Question 3)At dischargeAssessed through a validated survey, Lady-X Survey. Adapted from Gartner FR, de Bekker-Grob EW et al. Calculating preference weights for the labor and delivery index: A discrete choice experiment on women's birth experiences. Value Health. 2015 Sep; 856-864. Question 3: Taking your wishes seriously during childbirth. Scale 1-3. 1 = Very seriously, 2 = sufficiently, 3 = insufficiently Title: Lady-X Survey Definition: A survey to assess patient satisfaction and experience during their cervical ripening and induction. Ranges: 1-3 Best score: 1 Worst score: 3
Patient Satisfaction (Lady-X Survey, Question 4)At dischargeAssessed through a validated survey, Lady-X Survey. Adapted from Gartner FR, de Bekker-Grob EW et al. Calculating preference weights for the labor and delivery index: A discrete choice experiment on women's birth experiences. Value Health. 2015 Sep; 856-864. Question 4: Emotional support by healthcare professionals during childbirth. Scale 1-3. 1 = Very well supported, 2 = adequately supported, 3 = inadequately supported. Title: Lady-X Survey Definition: A survey to assess patient satisfaction and experience during their cervical ripening and induction. Ranges: 1-3 Best score: 1 Worst score: 3
Patient Satisfaction (Lady-X Survey, Question 5)At dischargeAssessed through a validated survey, Lady-X. Adapted from Gartner FR, de Bekker-Grob EW et al. Calculating preference weights for the labor and delivery index: A discrete choice experiment on women's birth experiences. Value Health. 2015 Sep; 856-864. Question 5: Feeling of security during childbirth: Scale 1-3. 1 = very safe, 2 = sufficiently safe, 3 = insufficiently safe. Title: Lady-X Survey Definition: A survey to assess patient satisfaction and experience during their cervical ripening and induction. Ranges: 1-3 Best score: 1 Worst score: 3
Patient Satisfaction (Lady-X Survey, Question 6)At dischargeAssessed through a validated survey, Lady-X. Adapted from Gartner FR, de Bekker-Grob EW et al. Calculating preference weights for the labor and delivery index: A discrete choice experiment on women's birth experiences. Value Health. 2015 Sep; 856-864. Question 6: Worries about the health of your child during childbirth. Scale 1-3; 1 = not worried, 2 = somewhat worried, 3 = very worried. Title: Lady-X Survey Definition: A survey to assess patient satisfaction and experience during their cervical ripening and induction. Ranges: 1-3 Best score: 1 Worst score: 3
Maximum Oxytocin RateAssessed from baseline to delivery, up to 3 days
Patient Satisfaction (Labor Pain Scale, Question 1)At dischargeAssessed through a survey (Labor pain scale). Survey assesses worst amount of pain during labor, overall amount of pain, pain associated with placement of Foley balloon, and likeliness of recommending method of induction to a friend. Questions 1: Worst amount of pain experienced during labor. Scale 0-100. 1 = no pain, 100 = pain as bad as it could possibly be. Title: Likert scale for patient satisfaction. Definition: A survey to assess patient satisfaction and experience during their cervical ripening and induction using a Likert scale. This is a way to assess from 0 to 100 patient satisfaction. Ranges: 0-100 Best score: 100 Worst score: 0
Patient Satisfaction (Labor Pain Scale, Question 2)At dischargeAssessed through a survey (Labor pain scale). Survey assesses worst amount of pain during labor, overall amount of pain, pain associated with placement of Foley balloon, and likeliness of recommending method of induction to a friend. Questions 2: Overall pain experienced during labor. Scale 0-100. 1 = no pain, 100 = pain as bad as it could possibly be. Title: Likert scale for patient satisfaction. Definition: A survey to assess patient satisfaction and experience during their cervical ripening and induction using a Likert scale. This is a way to assess from 0 to 100 patient satisfaction. Ranges: 0-100 Best score: 100 Worst score: 0
Patient Satisfaction (Labor Pain Scale, Question 3)At dischargeAssessed through a survey (Labor pain scale). Survey assesses worst amount of pain during labor, overall amount of pain, pain associated with placement of Foley balloon, and likeliness of recommending method of induction to a friend. Questions 3: Worse amount of pain experienced during the placement of the Foley balloon. Scale 0-100. 1 = no pain, 100 = pain as bad as it could possibly be. Title: Likert scale for patient satisfaction. Definition: A survey to assess patient satisfaction and experience during their cervical ripening and induction using a Likert scale. This is a way to assess from 0 to 100 patient satisfaction. Ranges: 0-100 Best score: 100 Worst score: 0
Patient Satisfaction (Labor Pain Scale, Question 4)At dischargeAssessed through a survey (Labor pain scale). Survey assesses worst amount of pain during labor, overall amount of pain, pain associated with placement of Foley balloon, and likeliness of recommending method of induction to a friend. Questions 4: How likely are you to recommend your method of induction to a friend or family member. Scale 0-100. 0= very unlikely, 100= very likely. Title: Likert scale for patient satisfaction. Definition: A survey to assess patient satisfaction and experience during their cervical ripening and induction using a Likert scale. This is a way to assess from 0 to 100 patient satisfaction. Ranges: 0-100 Best score: 100 Worst score: 0
Patient Satisfaction (Lady-X, Question 7)At dischargeAssessed through a validated survey, Lady-X. Adapted from Gartner FR, de Bekker-Grob EW et al. Calculating preference weights for the labor and delivery index: A discrete choice experiment on women's birth experiences. Value Health. 2015 Sep; 856-864. Question 7: Time until first contact with your child. Scale 1-3. 1 = Did not take long, 2 = Took quite a long time, 3 = Took a very long time. Title: Lady-X Survey Definition: A survey to assess patient satisfaction and experience during their cervical ripening and induction. Ranges: 1-3 Best score: 1 Worst score: 3

Countries

United States

Participant flow

Recruitment details

One additional patient was already scheduled to participate when the study met the projected number (128). The final (#129 patient) was offered participation in the study since she had already been scheduled for a study visit and possible induction of labor.

Participants by arm

ArmCount
Inpatient Group
Subjects in this arm will be seen in the outpatient setting, and if they qualify and are randomized to the inpatient (control) group, they will be admitted to labor and delivery the next day for cervical ripening with a transcervical Foley catheter. Inpatient cervical ripening: Subjects will undergo cervical ripening in the inpatient setting.
64
Outpatient Group (Intervention)
Subjects in this arm will undergo cervical ripening with a transcervical Foley catheter in the outpatient setting (treatment arm). The transcervical catheter will be placed in the office after confirmation of fetal well-being. They will then return the next morning to be admitted to labor and delivery for oxytocin administration. Outpatient cervical ripening: Subjects will undergo cervical ripening in the outpatient setting. The patients will then be scheduled to return the next morning for induction of labor.
65
Total129

Baseline characteristics

CharacteristicInpatient GroupOutpatient Group (Intervention)Total
Age, Continuous25.8 years
STANDARD_DEVIATION 4.2
26.6 years
STANDARD_DEVIATION 4.3
26.2 years
STANDARD_DEVIATION 4.3
Race/Ethnicity, Customized
Black
58 Participants55 Participants113 Participants
Race/Ethnicity, Customized
Hispanic
1 Participants2 Participants3 Participants
Race/Ethnicity, Customized
Race/Ethnicity
64 Participants65 Participants129 Participants
Race/Ethnicity, Customized
White
5 Participants8 Participants13 Participants
Region of Enrollment
United States
64 Participants65 Participants129 Participants
Sex: Female, Male
Female
64 Participants65 Participants129 Participants
Sex: Female, Male
Male
0 Participants0 Participants0 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
0 / 640 / 65
other
Total, other adverse events
0 / 640 / 65
serious
Total, serious adverse events
16 / 6412 / 65

Outcome results

Primary

Total Time From Admission to Delivery

Time frame: From baseline to the time of delivery (baseline is from admission), up to 7 days

ArmMeasureValue (MEAN)Dispersion
Inpatient GroupTotal Time From Admission to Delivery13.5 hoursStandard Deviation 7
Outpatient Group (Intervention)Total Time From Admission to Delivery12.4 hoursStandard Deviation 7.4
p-value: 0.38t-test, 2 sided
Secondary

Highest Maternal Intrapartum Temperature

Time frame: Assessed from baseline to delivery, up to 3 days

ArmMeasureValue (MEAN)Dispersion
Inpatient GroupHighest Maternal Intrapartum Temperature36.8 CelsiusStandard Deviation 0.4
Outpatient Group (Intervention)Highest Maternal Intrapartum Temperature36.7 CelsiusStandard Deviation 0.5
p-value: 0.06t-test, 2 sided
Secondary

Maximum Oxytocin Rate

Time frame: Assessed from baseline to delivery, up to 3 days

ArmMeasureValue (MEAN)Dispersion
Inpatient GroupMaximum Oxytocin Rate16.4 milliunits/minStandard Deviation 9
Outpatient Group (Intervention)Maximum Oxytocin Rate17.8 milliunits/minStandard Deviation 9.6
p-value: 0.42t-test, 2 sided
Secondary

Nonreassuring Fetal Heart Tracings 30-minutes After Foley Bulb Placement.

Time frame: From placement until 30 minutes.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Inpatient GroupNonreassuring Fetal Heart Tracings 30-minutes After Foley Bulb Placement.0 Participants
Outpatient Group (Intervention)Nonreassuring Fetal Heart Tracings 30-minutes After Foley Bulb Placement.0 Participants
p-value: 1Chi-squared
Secondary

Number of Neonates Admitted to the Neonatal Intensive Care Unit Admissions

The rates of neonatal intensive care unit admissions will be calculated.

Time frame: Assessed at time of delivery up to time of neonatal discharge, up to 30-days

ArmMeasureValue (NUMBER)
Inpatient GroupNumber of Neonates Admitted to the Neonatal Intensive Care Unit Admissions5 neonates
Outpatient Group (Intervention)Number of Neonates Admitted to the Neonatal Intensive Care Unit Admissions5 neonates
p-value: >0.9995% CI: [0.3, 3.2]Chi-squared
Secondary

Number of Neonates With a 5-minute Apgar Score Less Than 7

Apgar scores are assigned to all births. These are universally performed and assigned in the United States. The scoring system is between 0-10. 0 is the minimum score and 10 is the maximum. Lower scores are worse than higher scores.

Time frame: Assessed at time of delivery up to 5-minutes post-delivery.

ArmMeasureValue (NUMBER)
Inpatient GroupNumber of Neonates With a 5-minute Apgar Score Less Than 71 Neonates
Outpatient Group (Intervention)Number of Neonates With a 5-minute Apgar Score Less Than 70 Neonates
p-value: 0.5Chi-squared
Secondary

Number of Neonates With an Umbilical Cord Artery Base Deficit Less Than Negative 12

Base deficit is a lab value.

Time frame: Assessed at time of delivery up to 5-minutes post-delivery.

ArmMeasureValue (NUMBER)
Inpatient GroupNumber of Neonates With an Umbilical Cord Artery Base Deficit Less Than Negative 121 neonates
Outpatient Group (Intervention)Number of Neonates With an Umbilical Cord Artery Base Deficit Less Than Negative 120 neonates
p-value: >0.99Chi-squared
Secondary

Number of Neonates With Birth Injuries

Cephalohematomas, subgaleal hematomas, fracture of the clavicle, and scalp lacerations

Time frame: Assessed at time of delivery up to time of neonatal discharge, up to 30 days.

ArmMeasureValue (NUMBER)
Inpatient GroupNumber of Neonates With Birth Injuries2 neonates
Outpatient Group (Intervention)Number of Neonates With Birth Injuries1 neonates
p-value: 0.6295% CI: [0.05, 5.3]Chi-squared
Secondary

Number of Neonates With Umbilical Artery Cord pH < 7.1

Time frame: Assessed at time of delivery up to 5-minutes post-delivery.

ArmMeasureValue (NUMBER)
Inpatient GroupNumber of Neonates With Umbilical Artery Cord pH < 7.14 neonates
Outpatient Group (Intervention)Number of Neonates With Umbilical Artery Cord pH < 7.11 neonates
p-value: 0.3795% CI: [0.03, 2.3]Chi-squared
Secondary

Number of Participants Admitted Prior to the Scheduled Induction of Labor Time

Time frame: From placement of Foley bulb to 24 hours.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Inpatient GroupNumber of Participants Admitted Prior to the Scheduled Induction of Labor Time3 Participants
Outpatient Group (Intervention)Number of Participants Admitted Prior to the Scheduled Induction of Labor Time10 Participants
p-value: 0.0695% CI: [0.9, 11.4]Chi-squared
Secondary

Number of Participants Calling the Obstetrical Triage Unit

Time frame: From placement of Foley bulb to 24 hours.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Inpatient GroupNumber of Participants Calling the Obstetrical Triage Unit0 Participants
Outpatient Group (Intervention)Number of Participants Calling the Obstetrical Triage Unit4 Participants
p-value: 0.12Chi-squared
Secondary

Number of Participants Using Acetaminophen

Time frame: From placement of Foley bulb to 24 hours.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Inpatient GroupNumber of Participants Using Acetaminophen6 Participants
Outpatient Group (Intervention)Number of Participants Using Acetaminophen13 Participants
p-value: 0.0995% CI: [0.8, 5.3]Chi-squared
Secondary

Number of Participants Who Had a Cesarean Delivery

Time frame: Assessed from baseline to delivery.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Inpatient GroupNumber of Participants Who Had a Cesarean Delivery3 Participants
Outpatient Group (Intervention)Number of Participants Who Had a Cesarean Delivery2 Participants
p-value: 0.6895% CI: [0.1, 3.8]Chi-squared
Secondary

Number of Participants With an Operative Vaginal Delivery

Time frame: Assessed at delivery.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Inpatient GroupNumber of Participants With an Operative Vaginal Delivery6 Participants
Outpatient Group (Intervention)Number of Participants With an Operative Vaginal Delivery5 Participants
p-value: 0.7395% CI: [0.3, 2.6]Chi-squared
Secondary

Number of Participants With Chorioamnionitis

Time frame: Assessed from baseline to delivery.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Inpatient GroupNumber of Participants With Chorioamnionitis3 Participants
Outpatient Group (Intervention)Number of Participants With Chorioamnionitis3 Participants
p-value: >0.9995% CI: [0.2, 4.7]Chi-squared
Secondary

Number of Participants With Endometritis

Time frame: Assessed from delivery until 30 days post-discharge.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Inpatient GroupNumber of Participants With Endometritis1 Participants
Outpatient Group (Intervention)Number of Participants With Endometritis1 Participants
p-value: >0.9995% CI: [0.1, 15.4]Chi-squared
Secondary

Number of Participants With Meconium-stained Fluid

Time frame: Assessed from baseline to delivery.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Inpatient GroupNumber of Participants With Meconium-stained Fluid11 Participants
Outpatient Group (Intervention)Number of Participants With Meconium-stained Fluid8 Participants
p-value: 0.4395% CI: [0.3, 1.7]Chi-squared
Secondary

Number of Participants With Neonates With Shoulder Dystocia

Time frame: Assessed at delivery.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Inpatient GroupNumber of Participants With Neonates With Shoulder Dystocia7 Participants
Outpatient Group (Intervention)Number of Participants With Neonates With Shoulder Dystocia2 Participants
p-value: 0.0995% CI: [0.1, 1.3]Chi-squared
Secondary

Number of Participants With Readmission Within 30 Days

Time frame: Assessed from time of discharge until 30 days post-discharge.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Inpatient GroupNumber of Participants With Readmission Within 30 Days0 Participants
Outpatient Group (Intervention)Number of Participants With Readmission Within 30 Days1 Participants
p-value: >0.99Chi-squared
Secondary

Number of Participants With Spontaneous Rupture of Membranes Between Foley Bulb Placement and Admission

Time frame: From placement of Foley bulb to 24 hours.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Inpatient GroupNumber of Participants With Spontaneous Rupture of Membranes Between Foley Bulb Placement and Admission5 Participants
Outpatient Group (Intervention)Number of Participants With Spontaneous Rupture of Membranes Between Foley Bulb Placement and Admission4 Participants
p-value: 0.7495% CI: [0.2, 2.8]Chi-squared
Secondary

Patient Satisfaction (Labor Pain Scale, Question 1)

Assessed through a survey (Labor pain scale). Survey assesses worst amount of pain during labor, overall amount of pain, pain associated with placement of Foley balloon, and likeliness of recommending method of induction to a friend. Questions 1: Worst amount of pain experienced during labor. Scale 0-100. 1 = no pain, 100 = pain as bad as it could possibly be. Title: Likert scale for patient satisfaction. Definition: A survey to assess patient satisfaction and experience during their cervical ripening and induction using a Likert scale. This is a way to assess from 0 to 100 patient satisfaction. Ranges: 0-100 Best score: 100 Worst score: 0

Time frame: At discharge

Population: Title: Likert scale for patient satisfaction. Definition: A survey to assess patient satisfaction and experience during their cervical ripening and induction using a Likert scale. This is a way to assess from 0 to 100 patient satisfaction.~Ranges: 0-100 Best score: 100

ArmMeasureValue (MEDIAN)
Inpatient GroupPatient Satisfaction (Labor Pain Scale, Question 1)59.5 units on a scale
Outpatient Group (Intervention)Patient Satisfaction (Labor Pain Scale, Question 1)70 units on a scale
p-value: 0.12Wilcoxon (Mann-Whitney)
Secondary

Patient Satisfaction (Labor Pain Scale, Question 2)

Assessed through a survey (Labor pain scale). Survey assesses worst amount of pain during labor, overall amount of pain, pain associated with placement of Foley balloon, and likeliness of recommending method of induction to a friend. Questions 2: Overall pain experienced during labor. Scale 0-100. 1 = no pain, 100 = pain as bad as it could possibly be. Title: Likert scale for patient satisfaction. Definition: A survey to assess patient satisfaction and experience during their cervical ripening and induction using a Likert scale. This is a way to assess from 0 to 100 patient satisfaction. Ranges: 0-100 Best score: 100 Worst score: 0

Time frame: At discharge

Population: Title: Likert scale for patient satisfaction. Definition: A survey to assess patient satisfaction and experience during their cervical ripening and induction using a Likert scale. This is a way to assess from 0 to 100 patient satisfaction.~Ranges: 0-100 Best score: 100 Worst score: 0

ArmMeasureValue (MEDIAN)
Inpatient GroupPatient Satisfaction (Labor Pain Scale, Question 2)50 units on a scale
Outpatient Group (Intervention)Patient Satisfaction (Labor Pain Scale, Question 2)70 units on a scale
p-value: 0.06Wilcoxon (Mann-Whitney)
Secondary

Patient Satisfaction (Labor Pain Scale, Question 3)

Assessed through a survey (Labor pain scale). Survey assesses worst amount of pain during labor, overall amount of pain, pain associated with placement of Foley balloon, and likeliness of recommending method of induction to a friend. Questions 3: Worse amount of pain experienced during the placement of the Foley balloon. Scale 0-100. 1 = no pain, 100 = pain as bad as it could possibly be. Title: Likert scale for patient satisfaction. Definition: A survey to assess patient satisfaction and experience during their cervical ripening and induction using a Likert scale. This is a way to assess from 0 to 100 patient satisfaction. Ranges: 0-100 Best score: 100 Worst score: 0

Time frame: At discharge

Population: Title: Likert scale for patient satisfaction. Definition: A survey to assess patient satisfaction and experience during their cervical ripening and induction using a Likert scale. This is a way to assess from 0 to 100 patient satisfaction.~Ranges: 0-100 Best score: 100 Worst score: 0

ArmMeasureValue (MEDIAN)
Inpatient GroupPatient Satisfaction (Labor Pain Scale, Question 3)20 units on a scale
Outpatient Group (Intervention)Patient Satisfaction (Labor Pain Scale, Question 3)15 units on a scale
p-value: 0.83Wilcoxon (Mann-Whitney)
Secondary

Patient Satisfaction (Labor Pain Scale, Question 4)

Assessed through a survey (Labor pain scale). Survey assesses worst amount of pain during labor, overall amount of pain, pain associated with placement of Foley balloon, and likeliness of recommending method of induction to a friend. Questions 4: How likely are you to recommend your method of induction to a friend or family member. Scale 0-100. 0= very unlikely, 100= very likely. Title: Likert scale for patient satisfaction. Definition: A survey to assess patient satisfaction and experience during their cervical ripening and induction using a Likert scale. This is a way to assess from 0 to 100 patient satisfaction. Ranges: 0-100 Best score: 100 Worst score: 0

Time frame: At discharge

Population: Title: Likert scale for patient satisfaction. Definition: A survey to assess patient satisfaction and experience during their cervical ripening and induction using a Likert scale. This is a way to assess from 0 to 100 patient satisfaction.~Ranges: 0-100 Best score: 100 Worst score: 0

ArmMeasureValue (MEDIAN)
Inpatient GroupPatient Satisfaction (Labor Pain Scale, Question 4)99 units on a scale
Outpatient Group (Intervention)Patient Satisfaction (Labor Pain Scale, Question 4)99 units on a scale
p-value: 0.6Wilcoxon (Mann-Whitney)
Secondary

Patient Satisfaction (Lady-X, Question 7)

Assessed through a validated survey, Lady-X. Adapted from Gartner FR, de Bekker-Grob EW et al. Calculating preference weights for the labor and delivery index: A discrete choice experiment on women's birth experiences. Value Health. 2015 Sep; 856-864. Question 7: Time until first contact with your child. Scale 1-3. 1 = Did not take long, 2 = Took quite a long time, 3 = Took a very long time. Title: Lady-X Survey Definition: A survey to assess patient satisfaction and experience during their cervical ripening and induction. Ranges: 1-3 Best score: 1 Worst score: 3

Time frame: At discharge

Population: Title: Lady-X Survey Definition: A survey to assess patient satisfaction and experience during their cervical ripening and induction.~Ranges: 1-3 Best score: 1 Worst score: 3

ArmMeasureValue (MEDIAN)
Inpatient GroupPatient Satisfaction (Lady-X, Question 7)1 units on a scale
Outpatient Group (Intervention)Patient Satisfaction (Lady-X, Question 7)1 units on a scale
p-value: 0.24Wilcoxon (Mann-Whitney)
Secondary

Patient Satisfaction (Lady-X Survey, Question 1)

Assessed through a validated survey, Lady-X. Adapted from Gartner FR, de Bekker-Grob EW et al. Calculating preference weights for the labor and delivery index: A discrete choice experiment on women's birth experiences. Value Health. 2015 Sep; 856-864. Question 1: Presence of healthcare professionals during my birth. Scale 1-3. 1 = At all times, 2 = Most of the time, 3 = rarely Title: Lady-X Survey Definition: A survey to assess patient satisfaction and experience during their cervical ripening and induction. Ranges: 1-3 Best score: 1 Worst score: 3

Time frame: At discharge

Population: Title: Lady-X Survey Definition: A survey to assess patient satisfaction and experience during their cervical ripening and induction.~Ranges: 1-3 Best score: 1 Worst score: 3

ArmMeasureValue (MEDIAN)
Inpatient GroupPatient Satisfaction (Lady-X Survey, Question 1)1 units on a scale
Outpatient Group (Intervention)Patient Satisfaction (Lady-X Survey, Question 1)1 units on a scale
p-value: 0.29Wilcoxon (Mann-Whitney)
Secondary

Patient Satisfaction (Lady-X Survey, Question 2)

Assessed through a validated survey, Lady-X Survey. Adapted from Gartner FR, de Bekker-Grob EW et al. Calculating preference weights for the labor and delivery index: A discrete choice experiment on women's birth experiences. Value Health. 2015 Sep; 856-864. Question 2: Information given by the healthcare professionals during childbirth. Scale 1-3. 1 = I felt very well informed by the healthcare professionals, 2 = I felt adequately informed by the healthcare professionals, 3 = I felt inadequately informed by the healthcare professionals. Title: Lady-X Survey Definition: A survey to assess patient satisfaction and experience during their cervical ripening and induction. Ranges: 1-3 Best score: 1 Worst score: 3

Time frame: At discharge

Population: Title: Lady-X Survey Definition: A survey to assess patient satisfaction and experience during their cervical ripening and induction.~Ranges: 1-3 Best score: 1 Worst score: 3

ArmMeasureValue (MEDIAN)
Inpatient GroupPatient Satisfaction (Lady-X Survey, Question 2)1 units on a scale
Outpatient Group (Intervention)Patient Satisfaction (Lady-X Survey, Question 2)1 units on a scale
p-value: 0.42Wilcoxon (Mann-Whitney)
Secondary

Patient Satisfaction (Lady-X Survey, Question 3)

Assessed through a validated survey, Lady-X Survey. Adapted from Gartner FR, de Bekker-Grob EW et al. Calculating preference weights for the labor and delivery index: A discrete choice experiment on women's birth experiences. Value Health. 2015 Sep; 856-864. Question 3: Taking your wishes seriously during childbirth. Scale 1-3. 1 = Very seriously, 2 = sufficiently, 3 = insufficiently Title: Lady-X Survey Definition: A survey to assess patient satisfaction and experience during their cervical ripening and induction. Ranges: 1-3 Best score: 1 Worst score: 3

Time frame: At discharge

Population: Title: Lady-X Survey Definition: A survey to assess patient satisfaction and experience during their cervical ripening and induction.~Ranges: 1-3 Best score: 1 Worst score: 3

ArmMeasureValue (MEDIAN)
Inpatient GroupPatient Satisfaction (Lady-X Survey, Question 3)1 units on a scale
Outpatient Group (Intervention)Patient Satisfaction (Lady-X Survey, Question 3)1 units on a scale
p-value: 0.96Wilcoxon (Mann-Whitney)
Secondary

Patient Satisfaction (Lady-X Survey, Question 4)

Assessed through a validated survey, Lady-X Survey. Adapted from Gartner FR, de Bekker-Grob EW et al. Calculating preference weights for the labor and delivery index: A discrete choice experiment on women's birth experiences. Value Health. 2015 Sep; 856-864. Question 4: Emotional support by healthcare professionals during childbirth. Scale 1-3. 1 = Very well supported, 2 = adequately supported, 3 = inadequately supported. Title: Lady-X Survey Definition: A survey to assess patient satisfaction and experience during their cervical ripening and induction. Ranges: 1-3 Best score: 1 Worst score: 3

Time frame: At discharge

Population: Title: Lady-X Survey Definition: A survey to assess patient satisfaction and experience during their cervical ripening and induction.~Ranges: 1-3 Best score: 1 Worst score: 3

ArmMeasureValue (MEDIAN)
Inpatient GroupPatient Satisfaction (Lady-X Survey, Question 4)1 units on a scale
Outpatient Group (Intervention)Patient Satisfaction (Lady-X Survey, Question 4)1 units on a scale
p-value: 0.75Wilcoxon (Mann-Whitney)
Secondary

Patient Satisfaction (Lady-X Survey, Question 5)

Assessed through a validated survey, Lady-X. Adapted from Gartner FR, de Bekker-Grob EW et al. Calculating preference weights for the labor and delivery index: A discrete choice experiment on women's birth experiences. Value Health. 2015 Sep; 856-864. Question 5: Feeling of security during childbirth: Scale 1-3. 1 = very safe, 2 = sufficiently safe, 3 = insufficiently safe. Title: Lady-X Survey Definition: A survey to assess patient satisfaction and experience during their cervical ripening and induction. Ranges: 1-3 Best score: 1 Worst score: 3

Time frame: At discharge

Population: Title: Lady-X Survey Definition: A survey to assess patient satisfaction and experience during their cervical ripening and induction.~Ranges: 1-3 Best score: 1 Worst score: 3

ArmMeasureValue (MEDIAN)
Inpatient GroupPatient Satisfaction (Lady-X Survey, Question 5)1 units on a scale
Outpatient Group (Intervention)Patient Satisfaction (Lady-X Survey, Question 5)1 units on a scale
p-value: 0.57Wilcoxon (Mann-Whitney)
Secondary

Patient Satisfaction (Lady-X Survey, Question 6)

Assessed through a validated survey, Lady-X. Adapted from Gartner FR, de Bekker-Grob EW et al. Calculating preference weights for the labor and delivery index: A discrete choice experiment on women's birth experiences. Value Health. 2015 Sep; 856-864. Question 6: Worries about the health of your child during childbirth. Scale 1-3; 1 = not worried, 2 = somewhat worried, 3 = very worried. Title: Lady-X Survey Definition: A survey to assess patient satisfaction and experience during their cervical ripening and induction. Ranges: 1-3 Best score: 1 Worst score: 3

Time frame: At discharge

Population: Title: Lady-X Survey Definition: A survey to assess patient satisfaction and experience during their cervical ripening and induction.~Ranges: 1-3 Best score: 1 Worst score: 3

ArmMeasureValue (MEDIAN)
Inpatient GroupPatient Satisfaction (Lady-X Survey, Question 6)1 units on a scale
Outpatient Group (Intervention)Patient Satisfaction (Lady-X Survey, Question 6)1 units on a scale
p-value: 0.39Wilcoxon (Mann-Whitney)
Secondary

Patient Satisfaction Six Simple Questions, Q1

Assessed through validated survey, Six Simple Questions. Adapted from Harvey S, Rach D, et al. Evaluation of satisfaction with midwifery care. 2002 Dec; 18(4):260-7. 1=strongly agree, 4 = neutral, 7=strongly agree. Title: Six simple questions Definition: A survey to assess patient satisfaction during their cervical ripening and induction. Ranges: 1-7 Best score: 7 Worst score: 1

Time frame: At discharge.

Population: Title: Six simple questions Definition: A survey to assess patient satisfaction during their cervical ripening and induction.~Ranges: 1-7 Best score: 7 Worst score: 1

ArmMeasureValue (MEDIAN)
Inpatient GroupPatient Satisfaction Six Simple Questions, Q17 units on a scale
Outpatient Group (Intervention)Patient Satisfaction Six Simple Questions, Q17 units on a scale
p-value: 0.234Wilcoxon (Mann-Whitney)
Secondary

Patient Satisfaction (Six Simple Questions, Question 2)

Assessed through validated survey (Six simple questions, Q-2). Question 2: The person(s) responsible for my care are/were caring and compassionate. Scale 1-7. 1=strongly agree, 4 = neutral, 7=strongly agree. Title: Six simple questions Definition: A survey to assess patient satisfaction during their cervical ripening and induction. Ranges: 1-7 Best score: 7 Worst score: 1

Time frame: At discharge

Population: Title: Six simple questions Definition: A survey to assess patient satisfaction during their cervical ripening and induction.~Ranges: 1-7 Best score: 7 Worst score: 1

ArmMeasureValue (MEDIAN)
Inpatient GroupPatient Satisfaction (Six Simple Questions, Question 2)7 units on a scale
Outpatient Group (Intervention)Patient Satisfaction (Six Simple Questions, Question 2)7 units on a scale
p-value: 0.68Wilcoxon (Mann-Whitney)
Secondary

Patient Satisfaction (Six Simple Questions, Question 3)

Assessed through validated survey, Six Simple Questions. Adapted from Harvey S, Rach D, et al. Evaluation of satisfaction with midwifery care. 2002 Dec; 18(4):260-7. Question 3: Problems that have arisen up to now have not been dealt with effectively. Scale 1-7. 1=strongly agree, 4 = neutral, 7=strongly agree. Title: Six simple questions Definition: A survey to assess patient satisfaction during their cervical ripening and induction. Ranges: 1-7 Best score: 7 Worst score: 1

Time frame: At discharge

Population: Title: Six simple questions Definition: A survey to assess patient satisfaction during their cervical ripening and induction.~Ranges: 1-7 Best score: 7 Worst score: 1

ArmMeasureValue (MEDIAN)
Inpatient GroupPatient Satisfaction (Six Simple Questions, Question 3)1 units on a scale
Outpatient Group (Intervention)Patient Satisfaction (Six Simple Questions, Question 3)1 units on a scale
p-value: 0.77Wilcoxon (Mann-Whitney)
Secondary

Patient Satisfaction (Six Simple Questions, Question 4)

Assessed through validated survey, Six Simple Questions. Adapted from Harvey S, Rach D, et al. Evaluation of satisfaction with midwifery care. 2002 Dec; 18(4):260-7. Question 4: My needs have been addressed with appropriate consideration for my time. Scale 1-7. 1=strongly agree, 4 = neutral, 7=strongly agree. Title: Six simple questions Definition: A survey to assess patient satisfaction during their cervical ripening and induction. Ranges: 1-7 Best score: 7 Worst score: 1

Time frame: At discharge

Population: Title: Six simple questions Definition: A survey to assess patient satisfaction during their cervical ripening and induction.~Ranges: 1-7 Best score: 7 Worst score: 1

ArmMeasureValue (MEDIAN)
Inpatient GroupPatient Satisfaction (Six Simple Questions, Question 4)7 units on a scale
Outpatient Group (Intervention)Patient Satisfaction (Six Simple Questions, Question 4)7 units on a scale
p-value: 0.5Wilcoxon (Mann-Whitney)
Secondary

Patient Satisfaction (Six Simple Questions, Question 5)

Assessed through validated survey, Six Simple Questions. Adapted from Harvey S, Rach D, et al. Evaluation of satisfaction with midwifery care. 2002 Dec; 18(4):260-7. Question 5: The overall organization of my ca re has not been appropiate. Scale 1-7. 1=strongly agree, 4 = neutral, 7=strongly agree. Title: Six simple questions Definition: A survey to assess patient satisfaction during their cervical ripening and induction. Ranges: 1-7 Best score: 7 Worst score: 1

Time frame: At discharge

Population: Title: Six simple questions Definition: A survey to assess patient satisfaction during their cervical ripening and induction.~Ranges: 1-7 Best score: 7 Worst score: 1

ArmMeasureValue (MEDIAN)
Inpatient GroupPatient Satisfaction (Six Simple Questions, Question 5)1 units on a scale
Outpatient Group (Intervention)Patient Satisfaction (Six Simple Questions, Question 5)1 units on a scale
p-value: 0.75Wilcoxon (Mann-Whitney)
Secondary

Patient Satisfaction (Six Simple Questions, Question 6)

Assessed through validated survey, Six Simple Questions. Adapted from Harvey S, Rach D, et al. Evaluation of satisfaction with midwifery care. 2002 Dec; 18(4):260-7. Question 6: I would choose the same type of care for my next pregnancy. Scale 1-7. 1=strongly agree, 4 = neutral, 7=strongly agree. Title: Six simple questions Definition: A survey to assess patient satisfaction during their cervical ripening and induction. Ranges: 1-7 Best score: 7 Worst score: 1

Time frame: At discharge

Population: Title: Six simple questions Definition: A survey to assess patient satisfaction during their cervical ripening and induction.~Ranges: 1-7 Best score: 7 Worst score: 1

ArmMeasureValue (MEDIAN)
Inpatient GroupPatient Satisfaction (Six Simple Questions, Question 6)7 units on a scale
Outpatient Group (Intervention)Patient Satisfaction (Six Simple Questions, Question 6)7 units on a scale
p-value: 0.75Wilcoxon (Mann-Whitney)
Secondary

Postpartum Hemorrhage

Time frame: Assessed at delivery.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Inpatient GroupPostpartum Hemorrhage1 Participants
Outpatient Group (Intervention)Postpartum Hemorrhage0 Participants
p-value: 0.5Chi-squared
Secondary

Total Duration of Time From Rupture of Membranes Until Delivery

Time frame: Assessed from baseline to delivery, up to 3 days

ArmMeasureValue (MEAN)Dispersion
Inpatient GroupTotal Duration of Time From Rupture of Membranes Until Delivery6.2 hoursStandard Deviation 4.4
Outpatient Group (Intervention)Total Duration of Time From Rupture of Membranes Until Delivery5.5 hoursStandard Deviation 4.4
p-value: 0.38t-test, 2 sided
Secondary

Total Duration of Time of Neuraxial Anesthesia Use

Time frame: Assessed from baseline to delivery, up to 3 days

ArmMeasureValue (MEAN)Dispersion
Inpatient GroupTotal Duration of Time of Neuraxial Anesthesia Use8.7 hoursStandard Deviation 6.3
Outpatient Group (Intervention)Total Duration of Time of Neuraxial Anesthesia Use8.4 hoursStandard Deviation 6.9
p-value: 0.82t-test, 2 sided
Secondary

Total Hospital Duration

Time frame: From admission time to the hospital until discharge from the hospital, up to 7 days

ArmMeasureValue (MEAN)Dispersion
Inpatient GroupTotal Hospital Duration2.7 daysStandard Deviation 0.6
Outpatient Group (Intervention)Total Hospital Duration2.6 daysStandard Deviation 0.5
p-value: 0.29t-test, 2 sided

Source: ClinicalTrials.gov · Data processed: Feb 24, 2026