A multi-centre audit on the use of vaginal prostaglandin for the induction of labour

Summary

To induce labour, the National Institute for Health and Clinical Excellence (NICE) guideline recommend a maximum total dose of 6 mg of prostaglandin E₂ tablet or 4 mg of prostaglandin E₂ gel for women with an unfavourable cervix (3 mg gel for all other women). To determine clinicians’ compliance with these recommendations, the data of 1,424 women, who were induced at 10 obstetric units in England, were reviewed. A higher-than-recommended total dose was administered in 11% of the sample. Women who received prostaglandin tablets had a 2.5-fold greater likelihood to receive higher-than-recommended maximum total dose (OR: 2.6, 95% CI: 1.8–3.7; p < 0.001) and nine-times more likely to receive double the recommended maximum total dose (OR: 8.7, 95% CI: 2.9–24.4; p < 0.001). In this audit, 1 in 9 women, who underwent induction of labour, received higher than the recommended maximum total dose of vaginal prostaglandin.

Keywords:

• Induction of labour
• audit
• vaginal prostaglandin
• dinoprostone
• prostaglandin tablet
• prostaglandin gel