Intravenous (IV) Nitroglycerin for Versions in Nulliparous Women

NCT ID: NCT00896311

Last Updated: 2013-08-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

82 participants

Study Classification

INTERVENTIONAL

Study Start Date

2003-03-31

Study Completion Date

2008-02-29

Brief Summary

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Breech presentations (where a baby presents with feet or bottom down) have an increased risk of perinatal and neonatal complications, and are usually delivered by cesarean section. As an alternative, so that the baby can be delivered vaginally, an attempt can be made to turn the baby so that it is head down: this manoeuvre is called an external cephalic version (ECV).

Drugs that relax the uterus (tocolytic agents) are sometimes used to help improve ECV success rates. Nitroglycerin is a tocolytic agent, but intravenous nitroglycerin has not been tested as an agent to help ECV. There is some suggestion that nitroglycerin may be more helpful in women who have not previously been pregnant (nulliparous women) than in women who have been pregnant more than once (multiparous women), and so we have planned two trials.

This study is designed to answer the following questions for nulliparous women:

Will administration of IV nitroglycerin for uterine relaxation improve ECV success rates? Will an increase in ECV success result in a decreased cesarean section rate?

Detailed Description

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Conditions

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Breech Presentation Complication of Pregnancy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

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1

Treatment solution consisted of 100 micrograms/mL of nitroglycerin. After an initial 1ml dose, further doses could be given in 1-3mL increments until uterine relaxation was achieved, or up to a recommended maximum of 10mL

Group Type ACTIVE_COMPARATOR

IV Nitroglycerin

Intervention Type DRUG

IV injection, initial dose of 1ml, with further doses of 1-3mL, up to a recommended maximum of 10mL

2

Placebo solution was saline. After an initial 1ml dose, further doses could be given in 1-3mL increments until uterine relaxation was achieved, or up to a recommended maximum of 10mL

Group Type PLACEBO_COMPARATOR

Normal saline

Intervention Type DRUG

IV injection, initial dose of 1ml, with further doses of 1-3mL, up to a recommended maximum of 10mL

Interventions

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IV Nitroglycerin

IV injection, initial dose of 1ml, with further doses of 1-3mL, up to a recommended maximum of 10mL

Intervention Type DRUG

Normal saline

IV injection, initial dose of 1ml, with further doses of 1-3mL, up to a recommended maximum of 10mL

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* any non-cephalic presentation
* singleton pregnancy
* \>/= 37 weeks gestational age
* normal amniotic fluid volume
* reassuring fetal heart rate

Exclusion Criteria

* labor
* ruptured membranes
* history of third trimester bleeding
* any pre-existing uterine scar
* pregnancy induced hypertension and gestational diabetes
* oligohydramnios and polyhydramnios
* intrauterine growth restriction or macrosomia
* hypotension or any serious medical illness
* inability to comprehend the consent form
Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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University of Calgary

OTHER

Sponsor Role lead

Responsible Party

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Department of Obstetrics & Gynecology, Calgary Health Region

Principal Investigators

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Bruce B Allan, MD PhD

Role: PRINCIPAL_INVESTIGATOR

Calgary Health Region

Locations

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Foothills Medical Centre

Calgary, Alberta, Canada

Site Status

Peter Lougheed Centre

Calgary, Alberta, Canada

Site Status

Rockyview Hospital

Calgary, Alberta, Canada

Site Status

Countries

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Canada

References

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Hilton J, Allan B, Swaby C, Wah R, Jarrell J, Wood S, Ross S, Tran Q. Intravenous nitroglycerin for external cephalic version: a randomized controlled trial. Obstet Gynecol. 2009 Sep;114(3):560-567. doi: 10.1097/AOG.0b013e3181b05a19.

Reference Type BACKGROUND
PMID: 19701035 (View on PubMed)

Other Identifiers

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INVERT-01

Identifier Type: -

Identifier Source: org_study_id