Effect of mobility during induction of labor on time to delivery: a randomized controlled trial

Data regarding the effect of mobility during induction of labor on time to delivery are sparse. We aimed to evaluate whether enhancing mobility during induction of labor with extra amniotic balloon (EAB) using digital step counters (pedometers) and positive feedback, shortens time to delivery and affects labor experience. A prospective, single-center, randomized controlled trial was conducted. Women undergoing labor induction with EAB were recruited and randomized to either enhanced mobility (feedback group) or routine care (control group). Patients randomized to the feedback group received digital pedometers and personal feedback regarding their mobility at two set time points 4 and 8 hours after EAB placement. Personalized feedback was based on target mobility nomograms designed during a pilot period (figure). The primary outcome was time from EAB placement to delivery. Secondary outcomes included epidural use, Cesarean delivery rate, patient reported pain, satisfaction, and sense of control. Sample size was predetermined to detect a 15% between-group difference in the primary outcome. Between April 2019 and August 2020, 213 patients were recruited; 107 in the feedback group and 106 in the control group. Both groups had similar demographics characteristics. No differences were found between the groups in: (1) time from induction to delivery (19.2±8.9 Vs 20.05±9.12; P=0.49); (2) Epidural rate (85% Vs 83%; p=0.57); and (3) Cesarean delivery rate (14.9% Vs 11.3%; p=0.54). Reported satisfaction and sense of control were significantly higher in the feedback group (36±27 vs. 52±16.4; P= 0.001), while pain scores 8 hours from EAB placement were significantly lower (4±2.9 Vs 4.9±3.35; p=0.03) – table. Enhanced mobility during induction of labor with EAB did not shorten time to delivery. However, it improved labor experience.View Large Image Figure ViewerDownload Hi-res image Download (PPT)