IOL for PROM - Whats the protocol in your hospital?

Owl · Feb 21, 2012

Curly said: ↑

From NICE:

Women with prelabour rupture of membranes at term (at or over 37 weeks) should be offered a choice of induction of labour with vaginal PGE2[3] or expectant management.

Induction of labour is appropriate approximately 24 hours after prelabour rupture of the membranes at term.

In the absence of any evidence to inform the GDG on the appropriate method of induction, the GDG recognised that women with prelabour rupture of the membranes at term have for over two decades derived benefit from the widespread use of vaginal PGE
2 to induce labour in this situation. In addition, the GDG also considered the comfort, convenience and acceptability of vaginal PGE2 to the woman undergoing induction of labour. Vaginal PGE2 is less invasive than oxytocin,which requires intravenous access and continuous EFM, thus reducing women’s mobility during induction. On balance, the GDG reached a consensus that a vaginal PGE2 regimen is the preferred method of induction of labour for women with prelabour rupture of membranes at terms (referto Section 5.1.1).

Curly I'm pleased you put this, as I was starting to wonder where informed choice was! Surely woman should be told of both options and the risks? Does anyones trust do this?

I remember from my own experience I had to ask about expectant management, fight my right to not be induced and so many women I have encountered who have had babies had no idea what it was or that you were "allowed" do it!

Like to point out not critising just curious as I personally feel informed choice is important, but sometimes women aren't fully informed and don't know what questions to ask about their options. Is it a Midwives duty to provide all the facts, options and risk and then let the family decide?

Starrlamia · Feb 21, 2012

oh its nice to hear that you guys give a bit more time then here, most practitioners will try and rush you in for IOL after 12 hours and make a big fuss if you want to wait longer.

Curly · Feb 23, 2012

is that your policy in Canada?

I think most trusts should offer choice as standard however sometimesservice constraints do limit choice for women in circumstances that have a small time frame

The part I was trying to emphasise in the above quote was that PGE2 is recommended by NICE as the preferred method even in pre labour rupture of membranes over oxytocin use alone.

Log in or Sign up

IOL for PROM - Whats the protocol in your hospital?

Owl Active Member

Starrlamia Active Member

Curly Communications Manager

Share This Page