Cesarean Birth, Labor Induction
Conditions
Keywords
labor induction, cesarean birth, maternal morbidity
Brief summary
This proposal will determine if a Disparities in Labor Outcomes dashboard can be used as an implementation strategy to increase compliance to an evidence-based set of interventions for labor induction in a two-site difference-in-differences study design.
Interventions
OTHERDisparities in Labor Outcomes Dashboard
This Dashboard, a method of audit and feedback, will detail use of evidence-based practices and clinical outcomes on labor and delivery as attributed to individual clinicians on labor and delivery, stratified by race and ethnicity.
Sponsors
University of Pennsylvania
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Study design
Allocation
NON_RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Intervention model description
Difference-in-differences, neither site will have the intervention in the PRE period; one of two sites will have the intervention in the POST period
Eligibility
Sex/Gender
FEMALE
Healthy volunteers
No
Inclusion criteria
* full term (greater than or equal to 37 weeks gestation) * singleton gestations * intact membranes * undergoing an induction of labor requiring cervical ripening
Exclusion criteria
\- prior cesarean
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Fidelity to a labor induction protocol recommendation to perform all cervical exams performed in latent labor were performed less than or equal to 4.5 hours apart | from first cervical exam after admission for labor induction until the patient's cervical exam reaches 6cm dilation | Reported as binary - compliant or noncompliant; Time between cervical exams from first exam at admission for labor induction to reaching 6cm dilation will be calculated. If any time between exams is \>=4.5 hours, the outcome will be considered "non-compliant". If all are \<4.5 hours, the outcome will be "compliant." |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Cesarean delivery | single time point, at the time of delivery | Reported as binary (yes cesarean or no cesarean); mode of delivery (cesarean or vaginal) will be determined at the time of delivery |
| Maternal morbidity | from delivery until 30 days postpartum | greater than or equal to 1 of the following: endometritis, postpartum hemorrhage, blood transfusion, wound infection, venous thromboembolism, hysterectomy, intensive care unit admission, readmission within 30 days, and death |
| Time to delivery | as time from start of induction to delivery in hours | — |
Countries
United States
Contacts
CONTACTRebecca Hamm, MD MSCE
Outcome results
None listed