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Cost‐effectiveness of induction of labour at term with a F oley catheter compared to vaginal prostaglandin E 2 gel ( PROBAAT trial)
Author(s) -
Baaren GJ,
Jozwiak M,
Opmeer BC,
Oude Rengerink K,
Benthem M,
Dijksterhuis MGK,
Huizen ME,
Salm PCM,
Schuitemaker NWE,
Papatsonis DNM,
Perquin DAM,
Porath M,
Post JAM,
Rijnders RJP,
Scheepers HCJ,
Spaanderman M,
Pampus MG,
Leeuw JW,
Mol BWJ,
Bloemenkamp KWM
Publication year - 2013
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.12221
Subject(s) - medicine , caesarean section , foley catheter , labor induction , bishop score , vaginal delivery , cephalic presentation , confidence interval , cervix , obstetrics , catheter , prostaglandin , adverse effect , pregnancy , gynecology , anesthesia , oxytocin , surgery , biology , genetics , cancer
Objective To assess the economic consequences of labour induction with F oley catheter compared to prostaglandin E 2 gel. Design Economic evaluation alongside a randomised controlled trial. Setting Obstetric departments of one university and 11 teaching hospitals in the N etherlands. Population Women scheduled for labour induction with a singleton pregnancy in cephalic presentation at term, intact membranes and an unfavourable cervix; and without previous caesarean section. Methods Cost‐effectiveness analysis from a hospital perspective. Main outcome measures We estimated direct medical costs associated with healthcare utilisation from randomisation to 6 weeks postpartum. For caesarean section rate, and maternal and neonatal morbidity we calculated the incremental cost‐effectiveness ratios, which represent the costs to prevent one of these adverse outcomes. Results Mean costs per woman in the F oley catheter group ( n = 411) and in the prostaglandin E 2 gel group ( n = 408), were €3297 versus €3075, respectively, with an average difference of €222 (95% confidence interval −€157 to €633). In the F oley catheter group we observed higher costs due to longer labour ward occupation and less cost related to induction material and neonatal admissions. F oley catheter induction showed a comparable caesarean section rate compared with prostaglandin induction, therefore the incremental cost‐effectiveness ratio was not informative. F oley induction resulted in fewer neonatal admissions (incremental cost‐effectiveness ratio €2708) and asphyxia/postpartum haemorrhage (incremental cost‐effectiveness ratios €5257) compared with prostaglandin induction. Conclusions Foley catheter and prostaglandin E 2 labour induction generate comparable costs.