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Enhancing the induction of labour services at Nottingham University Hospitals NHS Trust: A retrospective cohort study
Megan Wright1, Faris Karouni2, Francis Barton3
1Department of Obstetrics and Gynaecology, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom.
Objective:
To assess the impact of introducing standardised electronic booking and multidisciplinary team (MDT) meetings on provision of Induction of labour (IoL) at Nottingham University Hospitals NHS Trust.
Design:
A retrospective cohort study.
Setting:
Two tertiary maternity hospitals in the UK.
Population:
Women and birthing people who gave birth between 01/01/2023 and 31/07/2024.
Methods:
The study period was divided into three-time frames: before, during and after implementation of the MDT and electronic booking service. Data were extracted from the electronic booking system (CAREFLOW) and maternity BADGERNET records and analysed with descriptive statistics followed by multinomial regression analysis of trends.
Main Outcome Measures:
Overall and early term IoL rates before, during, and after implementation of quality improvement measures.
Results:
Overall IoL rate was 38.9 % prior to implementing the electronic IOL service and MDT, increasing to 39.1 % during change implementation and reducing to 36.8 % post implementation. Early term (37 + 0 to 38 + 6 weeks) IoL saw a consistent fall, from 20.9 % to 19.2 % to 18.7 %. Unplanned caesarean section rates were higher for IoL than spontaneous labour at 32 % and 25 % respectively. Whilst IOL requests for post-dates were higher compared to other indications, the most common reason for performing IOL was for women presenting with reduced fetal movements (RFM).
Conclusions:
Successful implementation of the IoL MDT and electronic booking service has enabled standardised care provision and better utilisation of resources, for an optimal maternal and perinatal outcome.
