Is induction of labour by Propess (R) safe? A comparison of midwife-led versus obstetrician-led labour management

Abstract

This retrospective study compared maternal and fetal outcomes after labour induction, using a dinoprostone vaginal pessary (Propess (R)) in midwife-led and obstetrician-led labour management. Labour induction outcomes, delivery mode and rates of admission to the neonatal intensive care unit were compared. A total of 405 women, 40.5% (n = 164) from midwife-led units and 59.5% (n = 241) from an obstetricianled unit, participated. There was no statistically significant difference between the two groups in caesarean section rate or neonatal intensive care unit admission rates (p = 0.789 and 0.769, respectively). Non-reassuring fetal non-stress test and uterine hyperstimulation risks were higher in the obstetricianled unit (p = 0.003 and 0.001, respectively, and odds ratio (OR) 0.165, 95% CI: 0.117-0.232 and OR 0.218, 95% CI: 0.078-0.611, respectively). Postpartum blood transfusion rate was higher in the midwife-led units (p = 0.002, OR 8.082, 95% CI: 1.879-39.292). Labour induction with Propess (R) is safe during both midwife-led and obstetrician-led labour management.