Are we complying with NICE guidelines on the use of prostaglandin E2 for induction of labour? A survey of obstetric units in the UK.

To determine whether obstetric units in the UK comply with the recommendations by the National Institute for Clinical Excellence (NICE) on the maximum doses of intravaginal prostaglandin for induction of labour, a cross-sectional telephone survey of all obstetric units in the UK listed on Dr Foster's website was undertaken. The maximum doses recommended by NICE were exceeded by 86.4% (76/88) and 61.1% (55/90) of units that use intravaginal prostaglandin tablet and intravaginal prostaglandin gel, respectively. Units that use prostaglandin tablets were four times more likely to exceed the recommended maximum dose (OR = 4.03, 95% CI, 1.9 - 8.4), six times more likely to use 50% or more of the recommended maximum dose for nulliparous women (OR = 5.9, 95% CI, 3.1 - 11.0), and six times more likely to use 50% or more of the recommended maximum dose for multiparous women (OR = 6.5, 95% CI, 3.0 - 13.9). A majority of obstetric units in the UK exceed the maximum doses of intravaginal prostaglandin recommended by NICE for induction of labour.