Am J Perinatol 2021; 38(S 01): e71-e76
DOI: 10.1055/s-0040-1705170
Original Article

Patient Satisfaction with Outpatient Cervical Ripening in Parous Women

1  Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Center for Women's Reproductive Health, Birmingham, Alabama
2  Department of Obstetrics and Gynecology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts
,
Victoria C. Jauk
1  Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Center for Women's Reproductive Health, Birmingham, Alabama
,
David M. George
1  Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Center for Women's Reproductive Health, Birmingham, Alabama
,
Spencer G. Kuper
1  Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Center for Women's Reproductive Health, Birmingham, Alabama
,
Rodney K. Edwards
3  Department of Obstetrics and Gynecology, Section of Maternal-Fetal Medicine, University of Oklahoma College of Medicine, Oklahoma City, Oklahoma
,
Jeff M. Szychowski
1  Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Center for Women's Reproductive Health, Birmingham, Alabama
,
Sara E. Mazzoni
1  Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Center for Women's Reproductive Health, Birmingham, Alabama
,
Pamela Files
1  Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Center for Women's Reproductive Health, Birmingham, Alabama
,
Alan T. Tita
1  Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Center for Women's Reproductive Health, Birmingham, Alabama
,
Akila Subramaniam
1  Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Center for Women's Reproductive Health, Birmingham, Alabama
,
Lorie M. Harper
1  Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Center for Women's Reproductive Health, Birmingham, Alabama
› Author Affiliations

Abstract

Objective This study aimed to assess whether patient satisfaction differs between women beginning cervical ripening in the outpatient versus inpatient setting.

Study Design We performed a planned secondary analysis evaluating patient satisfaction randomized to outpatient versus inpatient cervical ripening. In the original randomized controlled trial, low-risk parous women ≥39 weeks who required cervical ripening for induction and had reassuring fetal heart rate monitoring were included and randomized to inpatient versus outpatient ripening with a transcervical Foley's catheter. All women were then admitted to the labor ward on the following day. Patient satisfaction was evaluated using three separate surveys. The first two surveys, Six Simple Questions and Lady-X, were previously validated. The third survey used visual analog scales to assess overall pain experienced during Foley's placement, overall pain experienced during labor, how likely they would be to choose the same type of care for their next pregnancy, and how likely they would be to recommend their method of cervical ripening to friends/family.

Results From May 2016 to October 2017, 129 women were randomized (outpatient, 65; inpatient, 64). Based on survey results, there was no difference in satisfaction between outpatient and inpatient cervical ripening with transcervical Foley's catheterization, with high satisfaction in both groups. Patients in both the outpatient and inpatient groups would choose the same type of care for their next pregnancy (on a scale of 1–7, median (25th–75th percentile): 7 [7–7] vs. 7 [6–7], respectively, p = 0.75) and would be very likely to recommend their method of induction to a friend or family member (on a scale of 0–100, 99 [80–100] vs. 99 [65–100], respectively, p = 0.60).

Conclusion Parous women's satisfaction does not differ between inpatient and outpatient cervical ripening with transcervical Foley's catheterization.

Key Points

  1. Outpatient cervical ripening may allow providers to incorporate the benefits of electively inducing women as well as decrease the time spent in the labor and delivery unit.

  2. Parous women's satisfaction does not differ between inpatient and outpatient cervical ripening with transcervical Foley.

  3. Additional prospective evaluation is warranted to further characterize patient preferences in relation to the location of cervical ripening.

Supplementary Material



Publication History

Received: 10 November 2019

Accepted: 28 January 2020

Publication Date:
03 March 2020 (online)

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