Can I go home after “the gel” for induction?

We will discuss “A randomised controlled trial of outpatient compared with inpatient cervical ripening with prostaglandin E2 (OPRA study) by Wilkinson and co-workers from 29 October 2014 for 7 days.

*This paper will be made free-to-view on 20 October 2014.

Start date: 29 October 2014 (the discussion will open for 7 days)

First hosted discussion session(s) starts at: GMT 7pm (UK time)

Host: @BlueJCHost

Platforms: Twitter

The Blue Journal Club is an international journal club on women’s health research based on Twitter (as @BlueJCHost). We start our conversation on the last Wednesday of each month and use the hashtag #BlueJC for our tweets. Simply add this hashtag (“#BlueJC”) to each tweet and we will capture it. Each #BlueJC opens for 7 days with an advertised start time. All BJOG #BlueJC papers also have complementary slide sets suitable for face-to-face journal clubs with your local colleagues. You can access the slide set of this paper here (data S1).

The discussion points are attached below (quoted from the published manuscript)

Scenario

A woman, G2P1, had induction of labour for post-date for first child. She is now 41+3 weeks. She has no other risk factors. She asked, “my last induction took days to work, can I go home after “the gel” and come in when I am in labour?”

 Description of research

Participants Women with uncomplicated term pregnancies, scheduled for induction of labour for post-dates or social reasons
Intervention Outpatient management during cervical ripening with prostaglandin E2 gel
Comparison Inpatient management during cervical ripening with prostaglandin E2 gel
Outcomes Syntocinon usage, obstetric interventions, maternal and neonatal complications
Study design Randomised controlled trial (1:1)

Discussion Points

  • Critically appraise this study using the RCT Critical Appraisal Sheet by the Centre for Evidence-based Medicine (http://bit.ly/1ailHBm).
  • Has the lack of blinding affected the internal and external validity of this clinical trial?
  • Was syntocinon usage an appropriate outcome for the clinical question raised?
  • Approximately half of the women did not receive the allocated intervention. How did it affect the interpretation of the results?
  • What could have been done to ensure the participants will receive their allocated intervention?
  • Can you summarise the available evidence in a single sentence? Is it strong enough to change your practice? (Data S1)

For those who want to understand hashtags, this may be a useful guide. For an introduction to #BlueJC, please refer to BJOG 2013;120:657–60. Follow @BlueJCHostthis blog and our Facebook page to receive news about #BlueJC.

2 thoughts on “Can I go home after “the gel” for induction?

  1. Hello, I was wondering when the article will be made free to view? As I type this it is 2108 in UK time on 20 October 2014, but Wiley Online Library is asking me to pay to read this article.

  2. Dear Minesh,

    Many thanks for raising this to us. We have looked into our scheduling and hope we could avoid similar problems in the future.

    Regards,

    BlueJC team

Comments are closed.