Analysis of Contemporary Labor Patterns Measured Via Transperineal Ultrasonography

NCT ID: NCT02393144

Last Updated: 2015-03-19

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

1000 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-02-28

Study Completion Date

2017-03-31

Brief Summary

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Primary aim of this study is to analyse contemporary labor patterns by measuring rate of dilatation and head descent via transperineal ultrasonography. Labor curves will be generated using data regarding rate of dilatation, head-descent obtained via transperineal ultrasonography. Factors which are known to effect duration of labor will be taken into account.

Detailed Description

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Intrapartum sonography is rapidly advancing field in the management of obstetrics labor. Traditional approach to labor management consists evaluation of cervical dilatation, head position and head descent via digital examinations. Rate of progress is evaluated using data of available labor curves. Unsatisfactory progression is either treated with labor augmentation or cesarean section depending on the degree and duration of labor retardation. Transperineal ultrasonography is able to assess cervical dilatation, fetal head descent and head position. Data obtained from analysis of labor via transperineal ultrasonography is not available. This research's primary aim is to generate labor curves using data obtained via ultrasonographic measurements.

Conditions

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Pregnancy Obstetric Labor

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Blinding Strategy

NONE

Study Groups

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Spontaneous labor arm

Women with term pregnancies whose labor started spontaneously. Spontaneous labor is determined by either spontaneous rupture of membranes at term and/or powerful, regular uterine contractions that cause cervical change. Women will be admitted to labor ward after initial assessment via transperineal ultrasonography. Labor augmentation will be performed for women with inadequate uterine contractions, i.e. contractions measuring less than Montevideo units, irregular weak uterine contractions. Analgesia will be provided via administration of 50 mg intramuscular meperidine at 2 hour intervals as required. Amniotomy will be performed for women with adequate cervical dilatation and fetal head-descent. Transperineal ultrasonography will be performed at irregular intervals to assess cervical dilatation, angle of progression and fetal head position. After birth, birth time, birth weight, APGAR scores, degree of perineal trauma, episiotomy use will be recorded.

Group Type OTHER

Transperineal ultrasonography, General Electric Healthcare Voluson Ultrasound System

Intervention Type DEVICE

Assessment of cervical dilatation, angle of progression and head position via transperineal ultrasonography

Cardiotocography, Bionet FC1400 Fetal Monitor

Intervention Type DEVICE

Assessment of strength of uterine contractions (Montevideo units) and fetal heart rate (beat per minute) with electronic monitors.

Amniotomy

Intervention Type OTHER

Artificial rupture of membranes to assess meconium staining and induce labor speed.

Analgesics, Opioid, Meperidine

Intervention Type DRUG

Administration of meperidine for labor analgesia.

Labor augmentation, Oxytocin

Intervention Type DRUG

Oxytocin infusion for augmentation of labor.

Induced labor arm

Women with term pregnancies who are induced for birth before the onset of spontaneous labor. Labor will be induced with either oxytocin infusion for women with high Bishop score, or labor will be induced with dinoprostone pessary for women requiring cervical ripening, i.e. poor. Women will be admitted to labor ward after initial assessment via transperineal ultrasonography. Analgesia will be provided via administration of 50 mg intramuscular meperidine at 2 hour intervals as required. Amniotomy will be performed for women with adequate cervical dilatation and fetal head-descent. Transperineal ultrasonography will be performed at irregular intervals to assess cervical dilatation, angle of progression and fetal head position. After birth, birth time, birth weight, APGAR scores, degree of perineal trauma, episiotomy use will be recorded.

Group Type OTHER

Transperineal ultrasonography, General Electric Healthcare Voluson Ultrasound System

Intervention Type DEVICE

Assessment of cervical dilatation, angle of progression and head position via transperineal ultrasonography

Cardiotocography, Bionet FC1400 Fetal Monitor

Intervention Type DEVICE

Assessment of strength of uterine contractions (Montevideo units) and fetal heart rate (beat per minute) with electronic monitors.

Amniotomy

Intervention Type OTHER

Artificial rupture of membranes to assess meconium staining and induce labor speed.

Analgesics, Opioid, Meperidine

Intervention Type DRUG

Administration of meperidine for labor analgesia.

Labor induction, Oxytocin

Intervention Type DRUG

Oxytocin infusion for induction of labor.

Cervical ripening, labor induction, Dinoprostone

Intervention Type DRUG

Administration of dinoprostone pessary for cervical ripening and labor induction.

Interventions

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Transperineal ultrasonography, General Electric Healthcare Voluson Ultrasound System

Assessment of cervical dilatation, angle of progression and head position via transperineal ultrasonography

Intervention Type DEVICE

Cardiotocography, Bionet FC1400 Fetal Monitor

Assessment of strength of uterine contractions (Montevideo units) and fetal heart rate (beat per minute) with electronic monitors.

Intervention Type DEVICE

Amniotomy

Artificial rupture of membranes to assess meconium staining and induce labor speed.

Intervention Type OTHER

Analgesics, Opioid, Meperidine

Administration of meperidine for labor analgesia.

Intervention Type DRUG

Labor augmentation, Oxytocin

Oxytocin infusion for augmentation of labor.

Intervention Type DRUG

Labor induction, Oxytocin

Oxytocin infusion for induction of labor.

Intervention Type DRUG

Cervical ripening, labor induction, Dinoprostone

Administration of dinoprostone pessary for cervical ripening and labor induction.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Term pregnancies
* Spontaneous labor
* Induced labor

Exclusion Criteria

* Preterm pregnancy
* Previous cesarean section
* Fetal presentation anomalies (breech etc.)
* 5th minute APGAR score lower than 7
* Instrumental delivery (forceps or vacuum use)
* Labor management that is not in accordance with "Safe Prevention of the Primary Cesarean Delivery" guideline by American College of Obstetrics and Gynecology.
* Fetus suffering visible birth trauma (laceration, fracture etc.)
Minimum Eligible Age

16 Years

Maximum Eligible Age

49 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Middle East Technical University

OTHER

Sponsor Role collaborator

Ankara University

OTHER

Sponsor Role lead

Responsible Party

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Erkan Kalafat

Research Assistant

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Acar F Koc, Professor

Role: STUDY_DIRECTOR

Department of Obstetrics and Gynecology, Ankara University Faculty of Medicine

Locations

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Ankara University Faculty of Medicine, Department of Obstetrics and Gynecology

Ankara, , Turkey (Türkiye)

Site Status RECRUITING

Countries

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Turkey (Türkiye)

Central Contacts

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Erkan Kalafat, M.D

Role: CONTACT

905334736998

Tuncay Yuce, M.D

Role: CONTACT

905055943521

Facility Contacts

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Erkan Kalafat

Role: primary

Other Identifiers

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001

Identifier Type: -

Identifier Source: org_study_id

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