new SOGC IOL guideline is in progress but likely several months before publication

Can someone copy & paste the link into the chat for us on their phone

www.menti.com

2556 0984

!!!!!!

Please don’t use term fetal distress - not defined and not recommended in FHS guideline

Cost analysis is really important — thanks for this perspective

I believe that cost is the experience of visit and the product combined. Gels range from $54-75 dependent on dose. The average outpatient assessment from hospital cost perspective only is $345-400

Miso 25 available in oral gel capsule - extensively used in East Coast and Toronto cost about $1.00 pre capsule

there is a very significant disconnect between perception among nursing toward early amniotomy and this evidence

at least at some of the academic sites

I agree, thus education and a shared understanding among all providers is key

Washout ! I don’t believe there is any good evidence. Who wants to do a RCT ?

Sometimes the reason in the book is " post dates" but there are other factors, especially in the high risk patients

MUMC cesarean section rate is between 35-38% over the past 5 years

So many important points in these wonderful rounds . 1. There is available data on IOL rate - we cab get this from BORM in our SOMCHN Network - the data is there we just dont have a culture of getting it and knowing it - we must change this and networks have jut been funded to do this 2. We cannot extrapolate the Arrive Trial to IOL other Gestations 3. The Arrive trial is not the only data showing that planned IOL reduces section rate - dont be sacred about implementing data that does not fit your Bias or by making up issues such as “ generalizability “ - BUT that does not mean we have to implement - the increase in demand on L and D is real 4. We must do a RCT on washout !!! 5. A wonderful Quality project - ONLY induce Post dates if T + 10 . We have the post term creeps at &T + 4 with “ other risk factors “

New pt info sheet re Oxytocin just published - 5 questions to ask

great presentation and overview. Thank you !

We (at MUMC) track all our L&D data including section rates monthly … as a hand count so readily available.

Great jobSorry I missed the start not sure if this was already mentioned - ways to avoid IOL the importance of membrane sweeps, if patient wants to BF - encouraging expression or pumping starting at 36 weeks and dates! Three dates TID lol there is evidence for that

Question: 2019 Swedish study — we saw reduced stillbirth rates if IOL was before 42 weeks. However, choosing to rate to for SOL (spontaneous onset of labour ) in the 41 week whether it is 41+0 to 41 +6 is similar - correct? I want to make sure I understand

In case anyone is interested Dr. Foster's student just published a systematic review on the quality of systematic reviews on IOL and found that the quality of studies in this area is not increasing over the last two decades. I think it's important to not only do research in this area, but do good (or better) quality research in this area. Here is the link to the paper: https://pubmed.ncbi.nlm.nih.gov/34495378/

Who were the residents that did the retrospective Review of washout ?

Ashley Musci and Kate Pizzuto (I believe)

I think it was prospective. Kate Pizzutto and Ashley Mucsi

Thank you :) are they here today?

could you please put back up the amniotomy slide?

This was a very relevant presentation. Can you remind us how to obtain the recording if we want to go back and review?

yes it does

thanks

I was always taught that when use Pit you should ARM otherwise not affective - this is what this slide shows

The presentation will be posted here

https://obsgyn.mcmaster.ca/faculty-and-staff-resources/star-cv

100% agree with Sarah - BUT implementation will be a challenge with current staffing

it is awkward as a patient to be asking for a well-researched induction via ARRIVE trial to witness the providers who don’t really want to do it. signed, me and Frankie

but that was post partum - noyt the same as getting the indictions in