Table 1.
Demographic and clinical characteristics of the pre- and post-implementation groups.
| Pre (n = 4214) n (%) | Post (n = 4295) n (%) | p-value | |
|---|---|---|---|
| Site | 0.76 | ||
| #1 | 2117 (50.2) | 2172 (50.6) | |
| #2 | 2097 (49.8) | 2123 (49.4) | |
| Maternal agea | 31 [26–34] | 31 [27–35] | 0.0003 |
| Race | 0.21 | ||
| Black | 1915 (45.4) | 1881 (43.8) | |
| White | 1666 (39.5) | 1747 (40.7) | |
| Asian | 291 (6.9) | 293 (6.8) | |
| Other | 342 (8.1) | 374 (8.7) | |
| Ethnicity | 0.076 | ||
| Hispanic | 292 (6.9) | 341 (7.9) | |
| Insurance | 0.87 | ||
| Private | 2533 (60.3) | 2597 (60.5) | |
| Medicaid/Medicare | 1667 (39.7) | 1697 (39.5) | |
| Maternal body mass index at last prenatal visit (mg/kg2)a | 31.5 [27.8–36.9] | 31.8 [28.1–37.1] | 0.048 |
| Gestational or pregestational diabetes | 399 (9.5) | 445 (10.4) | 0.17 |
| Chronic hypertension | 337 (8.0) | 401 (9.3) | 0.028 |
| Nulliparity | 2762 (65.5) | 2781 (64.7) | 0.44 |
| Gestational age at deliverya | 39.5 [38.6–40.4] | 39.5 [38.6–40.3] | 0.85 |
| Indication for induction | <0.0001 | ||
| Postdates/elective | 1356 (32.2) | 1351 (31.5) | |
| Maternal indicationsb | 1460 (34.7) | 1587 (37.0) | |
| Fetal indicationsc | 870 (20.7) | 747 (17.4) | |
| Otherd | 528 (12.5) | 610 (14.2) | |
| Modified Bishop scorea | 2 [0–3] | 2 [0–3] | <0.0001 |
| Cervical ripening agent utilized | <0.0001 | ||
| Misoprostol alone | 613 (14.6) | 751 (17.5) | |
| Cervical ripening balloon alone | 163 (3.9) | 129 (3.0) | |
| Misoprostol & ripening balloon simultaneously | 2051 (48.7) | 2014 (46.9) | |
| Oxytocin & ripening balloon simultaneously | 148 (3.5) | 103 (2.4) | |
| Misoprostol followed by ripening balloon | 971 (23.0) | 1090 (25.4) | |
| Oxytocin followed by ripening balloon | 65 (1.5) | 42 (1.0) | |
| Ripening balloon followed by misoprostol | 97 (2.3) | 95 (2.2) | |
| Ripening balloon followed by oxytocine | 96 (2.3) | 69 (1.6) | |
| Otherf | 10 (0.2) | 2 (0.1) | |
This study sample includes all patients admitted for labor induction at either the Hospital of the University of Pennsylvania or Pennsylvania Hospital over the study period meeting inclusion and exclusion criteria for use of the standardized labor induction protocol.
Median Interquartile range [IQR].
Examples include: chronic hypertension, gestational hypertension, preeclampsia, diabetes, renal disease, history of venous thromboembolism, cardiac disease or other chronic medical condition where induction was recommended.
Examples include: Oligohydramnios, intrauterine growth restriction, abnormality on fetal testing.
Examples of “other” include: history of an intrauterine fetal demise, vaginal bleeding at term, cholestasis.
If oxytocin was started while ripening balloon still in place.
Other includes Cervidil and starting oxytocin then stopping and proceeding with misoprostol.