Foley catheter vs. oral misoprostol to induce labour among hypertensive women in India: a cost-consequence analysis alongside a clinical trial

BJOG : an International Journal of Obstetrics and Gynaecology
Simon LeighAndrew D Weeks

Abstract

To determine the effectiveness and economic impact of two methods for induction of labour in hypertensive women, in low-resource settings. Cost-consequence analysis of a previously reported multicentre, parallel, open-label randomised trial. A total of 602 women with a live fetus, aged ≥18 years requiring delivery for pre-eclampsia or hypertension, in two public hospitals in Nagpur, India. We performed a formal economic evaluation alongside the INFORM clinical trial. Women were randomised to receive transcervical Foley catheterisation or oral misoprostol 25 mcg. Healthcare expenditure was calculated using a provider-side microcosting approach. Rates of vaginal this delivery within 24 hours of induction, healthcare expenditure per completed treatment episode. Induction with oral misoprostol resulted in a (mean difference) $20.6USD reduction in healthcare expenditure [95% CI (-) $123.59 (-) $72.49], and improved achievement of vaginal delivery within 24 hours of induction, mean difference 10% [95% CI (-2 to 17.9%), P = 0.016]. Oxytocin administration time was reduced by 135.3 minutes [95% CI (84.4-186.2 minutes), P < 0.01] and caesarean sections by 9.1% [95% CI (1.1-17%), P = 0.025] for those receiving oral misoprostol. Following...Continue Reading

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Citations

Oct 18, 2019·The Cochrane Database of Systematic Reviews·Marieke Dt de VaanMichel Boulvain
Mar 15, 2020·International Journal of Environmental Research and Public Health·Howard Hao LeePeng-Hui Wang
Jun 23, 2021·The Cochrane Database of Systematic Reviews·Robbie S KerrAndrew D Weeks

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NCT01801410

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