- Regular cervical exams during induction of labor (IOL) with oral misoprostol speed time to delivery, but patients do not view them favorably.
Why this matters
- Women undergoing IOL should discuss regular vs restricted exams with their providers.
- Induction time to vaginal delivery interval was shorter with regular vaginal exams vs restricted (24.3 vs 31.1 hours; P=.013).
- Women had higher satisfaction scores with restricted exams (P<.001 and would recommend this process to a friend>
- Vaginal delivery rate at 24 hours and satisfaction with birth process were no different between arms.
- Randomized, controlled, clinical interventions trial.
- Nulliparous women ≥37 weeks gestation with indication for IOL were randomly assigned into 2 groups:
- regular exams every 4 hours with an eye to expedited amniotomy and no further misoprostol when cervix is 2-3 cm (n=101) vs
- restricted examinations (n=103);
- both groups received oral misoprostol.
- At the 12-hour mark in both arms, a vaginal exam was performed if not in labor, and participants were asked about their satisfaction with their induction regimen.
- Primary outcomes were induction to vaginal delivery interval, 24-hour vaginal delivery rate, and patient satisfaction.
- Funding: Internal sources only.
- Not powered to assess cesarean delivery rate.