Pregnancy
Conditions
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
Study design
Eligibility
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
| Measure | Time frame |
|---|---|
| Total Time From Admission to Delivery | From baseline to the time of delivery (baseline is from admission), up to 7 days |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Highest Maternal Intrapartum Temperature | Assessed from baseline to delivery, up to 3 days | — |
| Number of Participants With Chorioamnionitis | Assessed from baseline to delivery. | — |
| Number of Participants With Meconium-stained Fluid | Assessed from baseline to delivery. | — |
| Number of Participants With Neonates With Shoulder Dystocia | Assessed at delivery. | — |
| Nonreassuring Fetal Heart Tracings 30-minutes After Foley Bulb Placement. | From placement until 30 minutes. | — |
| Total Duration of Time of Neuraxial Anesthesia Use | Assessed from baseline to delivery, up to 3 days | — |
| Total Duration of Time From Rupture of Membranes Until Delivery | Assessed from baseline to delivery, up to 3 days | — |
| Total Hospital Duration | From admission time to the hospital until discharge from the hospital, up to 7 days | — |
| Number of Participants Using Acetaminophen | From placement of Foley bulb to 24 hours. | — |
| Number of Participants Calling the Obstetrical Triage Unit | From placement of Foley bulb to 24 hours. | — |
| Number of Participants Admitted Prior to the Scheduled Induction of Labor Time | From placement of Foley bulb to 24 hours. | — |
| Number of Participants With Spontaneous Rupture of Membranes Between Foley Bulb Placement and Admission | From placement of Foley bulb to 24 hours. | — |
| Number of Participants Who Had a Cesarean Delivery | Assessed from baseline to delivery. | — |
| Number of Participants With an Operative Vaginal Delivery | Assessed at delivery. | — |
| Postpartum Hemorrhage | Assessed at delivery. | — |
| Number of Participants With Endometritis | Assessed from delivery until 30 days post-discharge. | — |
| Number of Participants With Readmission Within 30 Days | Assessed from time of discharge until 30 days post-discharge. | — |
| Number of Neonates With a 5-minute Apgar Score Less Than 7 | Assessed 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 < 7.1 | Assessed at time of delivery up to 5-minutes post-delivery. | — |
| Number of Neonates With an Umbilical Cord Artery Base Deficit Less Than Negative 12 | Assessed at time of delivery up to 5-minutes post-delivery. | Base deficit is a lab value. |
| Number of Neonates With Birth Injuries | Assessed 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 Admissions | Assessed at time of delivery up to time of neonatal discharge, up to 30-days | The rates of neonatal intensive care unit admissions will be calculated. |
| Patient Satisfaction Six Simple Questions, Q1 | At 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 discharge | 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 |
| Patient Satisfaction (Six Simple Questions, Question 3) | At 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. 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 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. 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 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. 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 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. 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 discharge | 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 |
| Patient Satisfaction (Lady-X Survey, Question 2) | At discharge | 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 |
| Patient Satisfaction (Lady-X Survey, Question 3) | At discharge | 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 |
| Patient Satisfaction (Lady-X Survey, Question 4) | At discharge | 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 |
| Patient Satisfaction (Lady-X Survey, Question 5) | At discharge | 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 |
| Patient Satisfaction (Lady-X Survey, Question 6) | At discharge | 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 |
| Maximum Oxytocin Rate | Assessed from baseline to delivery, up to 3 days | — |
| Patient Satisfaction (Labor Pain Scale, Question 1) | At discharge | 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 |
| Patient Satisfaction (Labor Pain Scale, Question 2) | At discharge | 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 |
| Patient Satisfaction (Labor Pain Scale, Question 3) | At discharge | 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 |
| Patient Satisfaction (Labor Pain Scale, Question 4) | At discharge | 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 |
| Patient Satisfaction (Lady-X, Question 7) | At discharge | 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 |
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
| Arm | Count |
|---|---|
| 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 |
| Total | 129 |
Baseline characteristics
| Characteristic | Inpatient Group | Outpatient Group (Intervention) | Total |
|---|---|---|---|
| Age, Continuous | 25.8 years STANDARD_DEVIATION 4.2 | 26.6 years STANDARD_DEVIATION 4.3 | 26.2 years STANDARD_DEVIATION 4.3 |
| Race/Ethnicity, Customized Black | 58 Participants | 55 Participants | 113 Participants |
| Race/Ethnicity, Customized Hispanic | 1 Participants | 2 Participants | 3 Participants |
| Race/Ethnicity, Customized Race/Ethnicity | 64 Participants | 65 Participants | 129 Participants |
| Race/Ethnicity, Customized White | 5 Participants | 8 Participants | 13 Participants |
| Region of Enrollment United States | 64 Participants | 65 Participants | 129 Participants |
| Sex: Female, Male Female | 64 Participants | 65 Participants | 129 Participants |
| Sex: Female, Male Male | 0 Participants | 0 Participants | 0 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 64 | 0 / 65 |
| other Total, other adverse events | 0 / 64 | 0 / 65 |
| serious Total, serious adverse events | 16 / 64 | 12 / 65 |
Outcome results
Total Time From Admission to Delivery
Time frame: From baseline to the time of delivery (baseline is from admission), up to 7 days
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Inpatient Group | Total Time From Admission to Delivery | 13.5 hours | Standard Deviation 7 |
| Outpatient Group (Intervention) | Total Time From Admission to Delivery | 12.4 hours | Standard Deviation 7.4 |
Highest Maternal Intrapartum Temperature
Time frame: Assessed from baseline to delivery, up to 3 days
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Inpatient Group | Highest Maternal Intrapartum Temperature | 36.8 Celsius | Standard Deviation 0.4 |
| Outpatient Group (Intervention) | Highest Maternal Intrapartum Temperature | 36.7 Celsius | Standard Deviation 0.5 |
Maximum Oxytocin Rate
Time frame: Assessed from baseline to delivery, up to 3 days
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Inpatient Group | Maximum Oxytocin Rate | 16.4 milliunits/min | Standard Deviation 9 |
| Outpatient Group (Intervention) | Maximum Oxytocin Rate | 17.8 milliunits/min | Standard Deviation 9.6 |
Nonreassuring Fetal Heart Tracings 30-minutes After Foley Bulb Placement.
Time frame: From placement until 30 minutes.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Inpatient Group | Nonreassuring 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 |
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
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Inpatient Group | Number of Neonates Admitted to the Neonatal Intensive Care Unit Admissions | 5 neonates |
| Outpatient Group (Intervention) | Number of Neonates Admitted to the Neonatal Intensive Care Unit Admissions | 5 neonates |
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.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Inpatient Group | Number of Neonates With a 5-minute Apgar Score Less Than 7 | 1 Neonates |
| Outpatient Group (Intervention) | Number of Neonates With a 5-minute Apgar Score Less Than 7 | 0 Neonates |
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.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Inpatient Group | Number of Neonates With an Umbilical Cord Artery Base Deficit Less Than Negative 12 | 1 neonates |
| Outpatient Group (Intervention) | Number of Neonates With an Umbilical Cord Artery Base Deficit Less Than Negative 12 | 0 neonates |
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.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Inpatient Group | Number of Neonates With Birth Injuries | 2 neonates |
| Outpatient Group (Intervention) | Number of Neonates With Birth Injuries | 1 neonates |
Number of Neonates With Umbilical Artery Cord pH < 7.1
Time frame: Assessed at time of delivery up to 5-minutes post-delivery.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Inpatient Group | Number of Neonates With Umbilical Artery Cord pH < 7.1 | 4 neonates |
| Outpatient Group (Intervention) | Number of Neonates With Umbilical Artery Cord pH < 7.1 | 1 neonates |
Number of Participants Admitted Prior to the Scheduled Induction of Labor Time
Time frame: From placement of Foley bulb to 24 hours.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Inpatient Group | Number of Participants Admitted Prior to the Scheduled Induction of Labor Time | 3 Participants |
| Outpatient Group (Intervention) | Number of Participants Admitted Prior to the Scheduled Induction of Labor Time | 10 Participants |
Number of Participants Calling the Obstetrical Triage Unit
Time frame: From placement of Foley bulb to 24 hours.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Inpatient Group | Number of Participants Calling the Obstetrical Triage Unit | 0 Participants |
| Outpatient Group (Intervention) | Number of Participants Calling the Obstetrical Triage Unit | 4 Participants |
Number of Participants Using Acetaminophen
Time frame: From placement of Foley bulb to 24 hours.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Inpatient Group | Number of Participants Using Acetaminophen | 6 Participants |
| Outpatient Group (Intervention) | Number of Participants Using Acetaminophen | 13 Participants |
Number of Participants Who Had a Cesarean Delivery
Time frame: Assessed from baseline to delivery.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Inpatient Group | Number of Participants Who Had a Cesarean Delivery | 3 Participants |
| Outpatient Group (Intervention) | Number of Participants Who Had a Cesarean Delivery | 2 Participants |
Number of Participants With an Operative Vaginal Delivery
Time frame: Assessed at delivery.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Inpatient Group | Number of Participants With an Operative Vaginal Delivery | 6 Participants |
| Outpatient Group (Intervention) | Number of Participants With an Operative Vaginal Delivery | 5 Participants |
Number of Participants With Chorioamnionitis
Time frame: Assessed from baseline to delivery.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Inpatient Group | Number of Participants With Chorioamnionitis | 3 Participants |
| Outpatient Group (Intervention) | Number of Participants With Chorioamnionitis | 3 Participants |
Number of Participants With Endometritis
Time frame: Assessed from delivery until 30 days post-discharge.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Inpatient Group | Number of Participants With Endometritis | 1 Participants |
| Outpatient Group (Intervention) | Number of Participants With Endometritis | 1 Participants |
Number of Participants With Meconium-stained Fluid
Time frame: Assessed from baseline to delivery.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Inpatient Group | Number of Participants With Meconium-stained Fluid | 11 Participants |
| Outpatient Group (Intervention) | Number of Participants With Meconium-stained Fluid | 8 Participants |
Number of Participants With Neonates With Shoulder Dystocia
Time frame: Assessed at delivery.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Inpatient Group | Number of Participants With Neonates With Shoulder Dystocia | 7 Participants |
| Outpatient Group (Intervention) | Number of Participants With Neonates With Shoulder Dystocia | 2 Participants |
Number of Participants With Readmission Within 30 Days
Time frame: Assessed from time of discharge until 30 days post-discharge.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Inpatient Group | Number of Participants With Readmission Within 30 Days | 0 Participants |
| Outpatient Group (Intervention) | Number of Participants With Readmission Within 30 Days | 1 Participants |
Number of Participants With Spontaneous Rupture of Membranes Between Foley Bulb Placement and Admission
Time frame: From placement of Foley bulb to 24 hours.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Inpatient Group | Number of Participants With Spontaneous Rupture of Membranes Between Foley Bulb Placement and Admission | 5 Participants |
| Outpatient Group (Intervention) | Number of Participants With Spontaneous Rupture of Membranes Between Foley Bulb Placement and Admission | 4 Participants |
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
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Inpatient Group | Patient 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 |
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
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Inpatient Group | Patient 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 |
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
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Inpatient Group | Patient 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 |
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
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Inpatient Group | Patient 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 |
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
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Inpatient Group | Patient Satisfaction (Lady-X, Question 7) | 1 units on a scale |
| Outpatient Group (Intervention) | Patient Satisfaction (Lady-X, Question 7) | 1 units on a scale |
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
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Inpatient Group | Patient 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 |
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
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Inpatient Group | Patient 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 |
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
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Inpatient Group | Patient 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 |
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
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Inpatient Group | Patient 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 |
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
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Inpatient Group | Patient 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 |
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
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Inpatient Group | Patient 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 |
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
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Inpatient Group | Patient Satisfaction Six Simple Questions, Q1 | 7 units on a scale |
| Outpatient Group (Intervention) | Patient Satisfaction Six Simple Questions, Q1 | 7 units on a scale |
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
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Inpatient Group | Patient 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 |
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
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Inpatient Group | Patient 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 |
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
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Inpatient Group | Patient 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 |
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
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Inpatient Group | Patient 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 |
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
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Inpatient Group | Patient 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 |
Postpartum Hemorrhage
Time frame: Assessed at delivery.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Inpatient Group | Postpartum Hemorrhage | 1 Participants |
| Outpatient Group (Intervention) | Postpartum Hemorrhage | 0 Participants |
Total Duration of Time From Rupture of Membranes Until Delivery
Time frame: Assessed from baseline to delivery, up to 3 days
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Inpatient Group | Total Duration of Time From Rupture of Membranes Until Delivery | 6.2 hours | Standard Deviation 4.4 |
| Outpatient Group (Intervention) | Total Duration of Time From Rupture of Membranes Until Delivery | 5.5 hours | Standard Deviation 4.4 |
Total Duration of Time of Neuraxial Anesthesia Use
Time frame: Assessed from baseline to delivery, up to 3 days
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Inpatient Group | Total Duration of Time of Neuraxial Anesthesia Use | 8.7 hours | Standard Deviation 6.3 |
| Outpatient Group (Intervention) | Total Duration of Time of Neuraxial Anesthesia Use | 8.4 hours | Standard Deviation 6.9 |
Total Hospital Duration
Time frame: From admission time to the hospital until discharge from the hospital, up to 7 days
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Inpatient Group | Total Hospital Duration | 2.7 days | Standard Deviation 0.6 |
| Outpatient Group (Intervention) | Total Hospital Duration | 2.6 days | Standard Deviation 0.5 |