Birth and Delivery · Labor and Birth

What can we do to reduce the associated costs in induction of labour of intrauterine growth restriction foetuses at term? A cost-analysis study

Duro-Gómez J, Garrido-Oyarzún MF, Rodríguez-Marín AB, de la Torre González AJ, Arjona-Berral JE, Castelo-Branco C

Published July 11, 2017 Archives of gynecology and obstetrics
DOI 10.1007/s00404-017-4458-x PMID 28698953

Abstract

Objective

To evaluate the costs associated with induction of labour in intrauterine growth restriction fetuses comparing different procedures.

Study Design

150 pregnancies at term diagnosed with intrauterine growth restriction and indication for induction of labour were included. 24 were ripened with misoprostol 25 μg tablets, 24 with dinoprostone 10 mg vaginal insert, and 77 with Cook® cervical ripening balloon. To determine the costs of induction of labour, method of induction, intrapartum medication, epidural analgesia, type of delivery, and maternal and neonatal admissions were considered. Statistical analysis was performed using the G-Stat 2.0 free statistical software. ANOVA test was used for comparisons between quantitative parametric variables. Chi-squared test or Fisher test was used for qualitative variables. A value of p < 0.05 was considered statistically significant.

Results

Up to 70.83% women in dinoprostone group gave birth within the first 24 h compared to 42.66% in misoprostol group and 36.36% in CG (p < 0.01). Misoprostol tablets were cheaper (9.45 ± 1.52 US dollars) than dinoprostone or Cook® balloon (41.67 ± 0 and 59.85 ± 0 54.45 ± 0 US dollars, respectively) (p < 0.01). Costs related to maternal admissions were higher in CG (475.13 ± 146.95$) than dinoprostone group (475.13 ± 146.95$) or MG (427.97 ± 112.65$) (p = 0.03). Total costs in misoprostol group (2765.18 ± 495.38$) were lower than in the dinoprostone group (3075.774 ± 896.14$) or Cook® balloon group (3228.02 ± 902.06$) groups.

Conclusions

Misoprostol for induction of labour had lower related costs than dinoprostone or Cook® balloon, with similar obstetrical and perinatal outcomes.

Topics

By this author

Birth and Delivery › Labor and Birth › Induction of Labor · Cost and Access › Cost of Care › Treatment Costs
Jorge Duro-Gómez, María Fernanda Garrido-Oyarzún, Ana Belén Rodríguez-Marín, Antonio Jesús de la Torre González, José Eduardo Arjona-Berral, Camil Castelo-Branco
J Duro-Gómez, M Garrido-Oyarzún, A Rodríguez-Marín, A González, J Arjona-Berral, C Castelo-Branco
PMID 28698953 28698953 DOI 10.1007/s00404-017-4458-x 10.1007/s00404-017-4458-x Duro-Gómez et al. 2017, Duro-Gómez 2017