Shetty Ashalatha, Burt Rhona, Rice Pat, Templeton Allan
Department of Obstetrics and Gynaecology, Aberdeen Maternity Hospital, Foresterhill, Aberdeen AB25 2ZL, Scotland, UK.
Eur J Obstet Gynecol Reprod Biol. 2005 Nov 1;123(1):56-61. doi: 10.1016/j.ejogrb.2005.03.004.
To evaluate the understanding and expectations of women undergoing labour induction, to assess their actual experience of the process and to compare their satisfaction with labour to those labouring spontaneously.
Four hundred and fifty women at term undergoing induction of labour and cervical ripening with prostaglandinE2 vaginal tablets and 450 women labouring spontaneously were recruited into the study. The induction group were requested to complete a questionnaire prior to the start of their induction process and another questionnaire post-delivery. The post-delivery questionnaire contained two sections, one pertaining to issues to do with the induction and the second with the actual labour process. The spontaneously labouring group was requested to complete a questionnaire post-delivery, which only contained the section pertaining to the actual labour process. The main outcome measures were satisfaction with labour, perception of pain and length of labour between the induced and spontaneous labour groups, and issues that the women might wish changed about their induction.
In the induction group, 34.7% were not satisfied with the information they received about the induction prior to the procedure and 27.2% expected to deliver within 12h of the administration of the inducing agent. Post-induction, 40% of the women felt the most important aspect they would like to change about their induction were they to have another one, would be the speed of the induction, 13.6% felt they might wish to take the inducing agent orally, 7% to have fewer vaginal examinations and 9% to have fewer complications. Among the women who returned questionnaires, 26.3% had a caesarean delivery in the induction group and 21.4% in the spontaneous labour group. Significantly more women were satisfied with their labour in the spontaneous labour group 79.5% versus 70.4%, RR 0.89, 95% CI 0.8-0.96, P=0.006).
Labour that is artificially induced does result in lower satisfaction rates as compared to that following spontaneous onset. The longer time delay between the start of the induction and the delivery plays a significant part in this, with the mode of administration of the inducing agent, more vaginal examinations and the increase in caesarean deliveries being perceived as secondary issues. There is a need to improve the information provided to women undergoing labour induction, to counter unrealistic expectations and thereby improve satisfaction.
评估引产女性的理解与期望，评估她们引产过程的实际体验，并将她们对分娩的满意度与自然分娩的女性进行比较。
招募450名足月使用前列腺素E2阴道片引产及促宫颈成熟的女性和450名自然分娩的女性参与研究。引产组在引产开始前和产后均需完成一份问卷。产后问卷包含两部分，一部分与引产相关问题有关，另一部分与实际分娩过程有关。自然分娩组只需在产后完成一份问卷，问卷仅包含与实际分娩过程有关的部分。主要结局指标为引产组与自然分娩组对分娩的满意度、疼痛感知及产程长度，以及女性希望在引产方面做出改变的问题。
在引产组中，34.7%的女性对引产术前获得的信息不满意，27.2%的女性期望在使用引产药物后12小时内分娩。引产术后，40%的女性认为如果再次引产，她们最希望改变的方面是引产速度，13.6%的女性觉得她们可能希望口服引产药物，7%的女性希望减少阴道检查次数，9%的女性希望减少并发症。在返回问卷的女性中，引产组有26.3%的女性进行了剖宫产，自然分娩组为21.4%。自然分娩组对分娩的满意度显著高于引产组，分别为79.5%和70.4%，相对危险度0.89，95%可信区间0.8 - 0.96，P = 0.006)。
与自然发动分娩相比，引产确实会导致较低的满意度。引产开始至分娩之间较长的时间延迟在其中起了重要作用，引产药物的给药方式、更多的阴道检查以及剖宫产率的增加被视为次要问题。有必要改善向引产女性提供的信息，以应对不切实际的期望，从而提高满意度。
