Induction of Labour in Norway: a Pilot for a Prospective National Audit
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 1,846
- 试验地点
- 1
- 主要终点
- Caesarean rate
研究概览
简要总结
The worldwide rate of induction of labour has been steadily increasing over the last 15 years, a trend that is reflected in Norway.
The overall aim of this study is to identify disparities between delivery departments in Norway in regards to:
- The overall rate of labour induction
- Main indication for the induction of labour.
- Induction methods used and protocols followed
- Maternal and fetal outcomes in induced births
Methods:
Observational study. Registration of induction indication, methods and outcomes in induced women. Data will be collected prospectively during a period of 4 months from 21 Norwegian delivery units using a web-based standardized case record form.
详细描述
In 2000 the Norwegian national induction rate was 8.8% of all births, but this increased to 21.8% in 2016. The regional induction rate varies between counties, varying from 17.7% of all births in Nordland to 24.0% in Rogaland. Individual units could have an even wider variation. There are reports of a high rate of induction in primiparous women. In some units, local audits have noted that in 2016, over 27% of primiparous women had their labour induced. Labour inductions in primiparous women (Robson group 2a) may be associated with an increased likelihood of caesarean sections and operative vaginal delivery. An increased caesarean rate in primiparous women will have implications for subsequent pregnancies. In Hammerfest Hospital, the caesarean section rate in Robson group 2a was 37% in 2016.
In Norway, induction of labour is offered in approximately 50 obstetric units. There are national guidelines available for the induction of labour from the Norwegian Gynaecological Society and from the Department of Health. , These guidelines are not categorical and leave the decision for the specific method, or regimen for labour induction, up to the attending gynaecologist or local departments. Thus, the national protocols between departments vary considerably and women living in different regions of Norway do not have the same options for induction of labour.
The Norwegian situation reflects the international situation where multiple induction protocols exist. There is no consensus regarding the medical criteria for the identification of women for induction of labour, nor the induction methods or protocols used.
Aim
The overall aim of this study is to identify disparities between delivery departments in Norway in regards to:
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •Induced women with no previous vaginal delivery
- •Gestational age from 23+0 weeks
- •Viable pregnancy at time of inclusion
排除标准
- •Previous vaginal delivery
结局指标
主要结局
Caesarean rate
时间窗: Throughout the study period of 3 months
Caesarean rate in induced women
次要结局
- Uterine tachysystole during labour(From start of labour as defined by opening of partograph until time of birth of baby)
- Time from induction to delivery(From start of medication/balloon until time of birth of baby)
- Indication for induction of labour(Throughout the study period of 3 months)
- Induction method used(Throughout the study period of 3 months)
- Composite infant outcome(From time of delivery until time of discharge of patient from maternity unit)
研究者
Ingvil Krarup Sørbye
Consultant
Oslo University Hospital