Dilapan-S Osmotic Dilator in Pre-induction of Labor

NCT ID: NCT02098382

Last Updated: 2015-07-29

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

Total Enrollment

125 participants

Study Classification

OBSERVATIONAL

Study Start Date

2013-05-31

Study Completion Date

2014-10-31

Brief Summary

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Non-interventional prospective data collection designed to evaluate clinical outcome on the efficacy of the use of Dilapan-S in the indication of labor pre-induction in women with/without a history of Caesarean section. The evaluation will be based on prospective data collection in at least four obstetrics centers in the Czech Republic.

Detailed Description

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Nowadays there is a rising need for non-pharmacological cervical ripening methods as the use of prostaglandins is frequently limited by various contraindications. Dilapan-S is a hygroscopic uterine neck dilator. Its mode of action consists in the hydrophilic properties of the device absorbing fluids from surrounding tissue structures, thus expanding the volume of Dilapan-S sticks which subsequently exert radial pressure on the surrounding structures (uterine neck) to dilate progressively. Endocervical pressure on the uterine neck results not only in its mechanical dilatation but pressure on endocervical structures also stimulates the production of endogenous prostaglandins, which promote cervical ripening through its collagenolytic action. Although Dilapan-S is widely used in labor pre-induction, published study data comparing its clinical efficacy and safety in females with/without caesarean section in medical history are lacking.

Conditions

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Uterine Cervical Incompetence

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Dilapan-S

125 Patients with / without caesarean section in their medical history

Dilapan-S

Intervention Type DEVICE

Dilapan-S synthetic osmotic dilator for cervical ripening prior to labor induction

Interventions

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Dilapan-S

Dilapan-S synthetic osmotic dilator for cervical ripening prior to labor induction

Intervention Type DEVICE

Other Intervention Names

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synthetic osmotic dilator

Eligibility Criteria

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Inclusion Criteria

* Single pregnancy
* Pregnancy more than 36 weeks
* Vertex presentation of the fetus
* Cervix Score less than 4 points

Exclusion Criteria

* Contraindication to vaginal delivery
* Pathological fetal station
* States after uterine body surgery - except for Caesarean section
* Clinical signs of uterine, vaginal or vulvar infection
* Fetus hypoxia (KTG recording evaluated as pathological prior to pre-induction initiation)
Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Medicem International CR s.r.o.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Ondrej Simetka, AssProf,PhD

Role: PRINCIPAL_INVESTIGATOR

Clinic of gynecology and obstetrics, University hospital of Ostrava, Czech Republic

Lukas Hruban, M.D.

Role: PRINCIPAL_INVESTIGATOR

Clinic of gynecology and obstetrics, University hospital of Brno, Czech Republic

Igor Michalec, M.D.

Role: PRINCIPAL_INVESTIGATOR

Clinic of gynecology and obstetrics, University hospital of Ostrava, Czech Republic

Radovan Vlk, M.D.

Role: PRINCIPAL_INVESTIGATOR

Clinic of gynecology and obstetrics, University hospital of II. Medicine college of Charles University in Prague, Czech Republic

Locations

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Clinic of Gynecology&Obstetrics, University hospital in Brno and Masaryk University Medical School

Brno, , Czechia

Site Status

Countries

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Czechia

References

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Serhal P, Ranieri DM, Khadum I, Wakim RA. Cervical dilatation with hygroscopic rods prior to ovarian stimulation facilitates embryo transfer. Hum Reprod. 2003 Dec;18(12):2618-20. doi: 10.1093/humrep/deg477.

Reference Type BACKGROUND
PMID: 14645181 (View on PubMed)

Chen FC, Bergann A, Krosse J, Merholz A, David M. Isosorbide mononitrate vaginal gel versus misoprostol vaginal gel versus Dilapan-S for cervical ripening before first trimester curettage. Eur J Obstet Gynecol Reprod Biol. 2008 Jun;138(2):176-9. doi: 10.1016/j.ejogrb.2007.09.009. Epub 2007 Nov 5.

Reference Type BACKGROUND
PMID: 17980952 (View on PubMed)

Allen RH, Goldberg AB; Board of Society of Family Planning. Cervical dilation before first-trimester surgical abortion (<14 weeks' gestation). SFP Guideline 20071. Contraception. 2007 Aug;76(2):139-56. doi: 10.1016/j.contraception.2007.05.001. Epub 2007 Jul 10.

Reference Type BACKGROUND
PMID: 17656184 (View on PubMed)

Samuel MI, Parsons JH. Hygroscopic dilator (Dilapan-S) and misoprostol combination for the early first-trimester termination of pregnancy: a pilot study. J Fam Plann Reprod Health Care. 2009 Jan;35(1):45-7. doi: 10.1783/147118909787072234.

Reference Type BACKGROUND
PMID: 19126319 (View on PubMed)

Wilson LC, Meyn LA, Creinin MD. Cervical preparation for surgical abortion between 12 and 18 weeks of gestation using vaginal misoprostol and Dilapan-S. Contraception. 2011 Jun;83(6):511-6. doi: 10.1016/j.contraception.2010.10.004. Epub 2010 Dec 3.

Reference Type BACKGROUND
PMID: 21570547 (View on PubMed)

Chambers DG, Willcourt RJ, Laver AR, Baird JK, Herbert WY. Comparison of Dilapan-S and laminaria for cervical priming before surgical pregnancy termination at 17-22 weeks' gestation. Int J Womens Health. 2011;3:347-52. doi: 10.2147/IJWH.S25551. Epub 2011 Oct 20.

Reference Type BACKGROUND
PMID: 22114527 (View on PubMed)

Lyus R, Lohr PA, Taylor J, Morroni C. Outcomes with same-day cervical preparation with Dilapan-S osmotic dilators and vaginal misoprostol before dilatation and evacuation at 18 to 21+6 weeks' gestation. Contraception. 2013 Jan;87(1):71-5. doi: 10.1016/j.contraception.2012.07.006. Epub 2012 Aug 13.

Reference Type BACKGROUND
PMID: 22898362 (View on PubMed)

Fox MC, Krajewski CM. Cervical preparation for second-trimester surgical abortion prior to 20 weeks' gestation: SFP Guideline #2013-4. Contraception. 2014 Feb;89(2):75-84. doi: 10.1016/j.contraception.2013.11.001. Epub 2013 Nov 11.

Reference Type BACKGROUND
PMID: 24331860 (View on PubMed)

Bartz D, Maurer R, Allen RH, Fortin J, Kuang B, Goldberg AB. Buccal misoprostol compared with synthetic osmotic cervical dilator before surgical abortion: a randomized controlled trial. Obstet Gynecol. 2013 Jul;122(1):57-63. doi: 10.1097/AOG.0b013e3182983889.

Reference Type BACKGROUND
PMID: 23743471 (View on PubMed)

Borgatta L, Roncari D, Sonalkar S, Mark A, Hou MY, Finneseth M, Vragovic O. Mifepristone vs. osmotic dilator insertion for cervical preparation prior to surgical abortion at 14-16 weeks: a randomized trial. Contraception. 2012 Nov;86(5):567-71. doi: 10.1016/j.contraception.2012.05.002. Epub 2012 Jun 6.

Reference Type BACKGROUND
PMID: 22682721 (View on PubMed)

Borgatta L, Lopatinsky I, Shaw FM. Overcoming unsatisfactory colposcopy. Use of osmotic dilators. J Reprod Med. 1997 May;42(5):271-5.

Reference Type BACKGROUND
PMID: 9172116 (View on PubMed)

Newmann SJ, Sokoloff A, Tharyil M, Illangasekare T, Steinauer JE, Drey EA. Same-day synthetic osmotic dilators compared with overnight laminaria before abortion at 14-18 weeks of gestation: a randomized controlled trial. Obstet Gynecol. 2014 Feb;123(2 Pt 1):271-278. doi: 10.1097/AOG.0000000000000080.

Reference Type BACKGROUND
PMID: 24402587 (View on PubMed)

Roztocil A, Pilka L, Jelinek J, Koudelka M, Miklica J. A comparison of three preinduction cervical priming methods: prostaglandin E2 gel, Dilapan S rods and Estradiol gel. Ceska Gynekol. 1998 Feb;63(1):3-9.

Reference Type RESULT
PMID: 9650373 (View on PubMed)

Other Identifiers

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DIS2013-002

Identifier Type: -

Identifier Source: org_study_id

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