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

Autor: Duro-Gómez J; Hospital Universitario Reina Sofía, Av. Menéndez Pidal, s/n, 14004, Córdoba, Spain., Garrido-Oyarzún MF; Clínica Universidad de los Andes, Avda. Plaza 2501, Las Condes, Santiago de Chile, Chile., Rodríguez-Marín AB; Hospital Universitario Reina Sofía, Av. Menéndez Pidal, s/n, 14004, Córdoba, Spain., de la Torre González AJ; Hospital Universitario Reina Sofía, Av. Menéndez Pidal, s/n, 14004, Córdoba, Spain., Arjona-Berral JE; Hospital Universitario Reina Sofía, Av. Menéndez Pidal, s/n, 14004, Córdoba, Spain., Castelo-Branco C; Clinic Institute of Gynecology, Obstetrics and Neonatology, Hospital Clinic-Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, c/Villarroel 170, 08036, Barcelona, Spain. castelobranco@ub.edu.; Department of Gynecology and Obstetrics, Hospital Clinic I Provincial de Barcelona, c/Villarroel 170, 08036, Barcelona, Spain. castelobranco@ub.edu.
Jazyk: angličtina
Zdroj: Archives of gynecology and obstetrics [Arch Gynecol Obstet] 2017 Sep; Vol. 296 (3), pp. 483-488. Date of Electronic Publication: 2017 Jul 11.
DOI: 10.1007/s00404-017-4458-x
Abstrakt: 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.
Databáze: MEDLINE
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