SWEPIS - SWEdish Post Induction Study

Aim 

The aim of this study is to evaluate if a policy of induction of labour at 41 W (early induction) is superior, in terms of neonatal and maternal outcomes, women’s and their partners experiences and health care economics as compared to expectant management and induction at 42+0 (late induction) in healthy women with a low risk singleton pregnancy (Elden et al., 2016).

Study 1: Individual in-depth interviews with 10 women at W41 + 1-6 days. Phenomenology with a reflective life world approach was used in the analysis (Wessberg, Lundgren, & Elden, 2017).

Study 2: Individual in-depth interviews with women 3 months after delivery. Hermeneutic analysis is in progress

Study 3: Stillbirths and perinatal mortality in induction of labor at W41 compared to induction of labor in W 42. A nationwide register study from Sweden.

Study 4: Individual in-depth interviews with 24 women participating in SWEPIS randomized to induction of labor at W 41 (n=8), to induction of labor in W 42 (n=8) and women that does not want to get their labor induced (n=8). Phenomenology with a reflective life world approach will be used in the analysis

Study 5: The aim of this study is to investigate if childbirth experiences (CEQ) are different after elective induction of labour at 41 W and expectant management and induction at 42 W?

Study 6: The aim of this study is to investigate if the personality (Big Five), self-efficacy (General Self-Efficacy Scale: GES), pain catastrophizing (Pain Catastrophizing Scale: PCS), psychosocial and demographic factors are associated with positive or negative childbirth experiences (CEQ) after elective induction of labour at 42 W, and expectant management and induction of labour at 42 W (n= 2500-3000 women). If so, how do these factors contribute to the different childbirth experiences (CEQ)?

Study 7: The aim with this register-based randomized multicenter study is to evaluate if induction of labour at 41 W (early induction) is superior, in terms of neonatal and maternal outcomes, as compared to expectant management and induction at 42 W (late induction) in healthy women with a low risk singleton pregnancy (n=10 038 women).

Study 8: The aim of this study is to investigate if personality, self-efficacy, pain catastrophizing, psychosocial and demographic factors contribute to maternal outcomes, after induction of labour at 41 W as compared to expectant management and induction at 42+0 in healthy women (n= 2500-3000) with a low risk singleton pregnancy.

Study 9. Cost-effectiveness analyses of if induction of labour at 41 W (early induction) compared to expectant management and induction at 42+0 (late induction) in healthy women (n= 2500-3000) with a low risk singleton pregnancy. 

Publications 

Nilver H, Lundgren I, Elden H, Dencker A. Women’s lived experience of induction of labour in late and postterm pregnancy within the Swedish postterm induction study - A phenomenological study. Iinternational journal of Qualitative Studies on Health and Well-being. https://doi.org/10.1080/17482631.2022.2056958

Alkmark M, Carlsson Y, Wennerholm UB, Saltved S, Bergh C, Carlsson Y, Elden H, Fadl H, Jonsson M, Ladfors L, Sengpiel V, Wesström J, Hagberg H, Svensson M. Induction of labour at 41 weeks of gestation versus expectant management and induction of labour at 42 weeks of gestation: a cost-effectiveness analysis. BJOG, Publicerad 17 september 2021. https://obgyn.onlinelibrary.wiley.com/action/doSearch?ContribAuthorRaw=Alkmark%2C+M%C3%A5rten&SeriesKey=14710528 

Alkmark M, Berglin L, Dencker A, Elden H, Gejervall A-L, I Hagberg H, Karlsson EK, Strandell A, Svanberg T, Svensson M, Wennerholm U-B, Wessberg A, Jivegård L. (2020). Induction of labour at 41 or 42 weeks of gestation.  Göteborg: Västra Götalandsregionen, Sahlgrenska Universitetssjukhuset, HTA-centrum: 2020. Regional activity based HTA 2020:111 
 

Wennerholm UB, Saltvedt S, Wessberg A, Alkmark M, […], Elden H**, Stephansson O**, Hagberg H**. Induction of labour at 41 weeks versus expectant management and induction of labour at 42 weeks (SWEdish Post-term Induction Study, SWEPIS): multicentre, open label, randomised, superiority trial. BMJ 2019; 367 doi: https://doi.org/10.1136/bmj.l6131  BMJ 2019;367:l6131**shared senior authorship.  

Wessberg A, Lundgren I, Elden H. Late-term pregnancy: Navigating in unknown waters- A hermeneutic study. Women and Birth. 2019 Apr 1:S1871-5192(18)30244-0. doi: 10.1016/j.wombi.2019.03.011. PMID: 30948282  

Wessberg A, Lundgren I, Elden H. Being in limbo: Women’s lived experiences of post term pregnancy: A Swedish phenomenological interview study. BMC Pregnancy Childbirth. 2017 Jun 2;17(1):162. doi: 10.1186/s12884-017-1342-4.PMID: 28578685  

Elden, H., Hagberg, H., Wessberg, A., Sengpiel, V., Herbst, A., Bullarbo, M.,. Wennerholm, U. B. (2016). Study protocol of SWEPIS a Swedish multicentre register based randomised controlled trial to compare induction of labour at 41 completed gestational weeks versus expectant management and induction at 42 completed gestational weeks. BMC Pregnancy Childbirth, 16, 49.

Nilve’r H, Wessberg A, Dencker A, Hagberg H, Wennerholm UB, Fadl H, Sengpiel V, Lundgren I, Bergh C, Wikströ AK, Saltved S, Wesström j, Elden H. Women’s childbirth experience in the Swedish Post-term Induction Study (SWEPIS): a multicentre, randomised, controlled trial. BMJ Open 2021;11:e042340. doi:10.1136/bmjopen-2020-042340 

Alkmark M, Carlsson Y, Brismar Wendel S, Elden H, Fadl H^, Jonsson M, Ladfors L, Saltvedt S, Sengpiel V, Wessberg A, Wikström AK, Hagberg H, Wennerholm UB. Efficacy and safety of oral misoprostol vs transvaginal balloon catheter for labor induction: An observational study within the SWEdish Postterm Induction Study (SWEPIS). AOGS, Acta Obstet Gyn Scand Accepted 210318