A Pilot RCT on the Management of Term Prelabour Rupture of Membranes

NCT ID: NCT02872883

Last Updated: 2016-11-16

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

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-11-30

Study Completion Date

2017-11-30

Brief Summary

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This is a pilot study that will eventually result in a main randomised controlled trial that will look at what management is associated with a higher rate of normal birth and a lower rate of chorioamnionitis (maternal infection) when women break their waters but labour does not start. Spontaneous rupture of the membranes (when the waters break) at term (37-42 weeks gestation) is a physiological event that happens during labour. However, according to Gunn et al. (1970) in 8-10 % of the cases the membranes rupture before labour starts. The time between the rupture and the onset of labour is called latent phase and time wise is variable.

Studies have showed no statistically significant differences in terms of neonatal infection or chorioamnionitis when the investigators induce labour with prostaglandins compared to when labour starts spontaneously (Hannah et al 1996). Seaward et al. (1997) noted a number of confounding factors that might relate to the incidence of chorioamnionitis (maternal infection), the strongest predictor was having more than 8 vaginal examinations since the rupture of membranes and before delivery which was a stronger predictor than the duration of the latent phase. It is thought that by reducing the number of internal examinations, chorioamnionitis may be reduced, and hence neonatal infection may also be reduced. The main RCT will compare clinical outcomes and maternal satisfaction when women consent to be randomized to four groups: (1) Active management and routine internal examinations during labour, (2) Active management and reduced internal examinations, (3) Expectant management and routine internal examinations, (4) Expectant management and reduced internal examinations.

This application seeks ethics approval for the pilot phase to ensure that a definitive study can be undertaken appropriately. It is important to test that all the components work well individually and as a whole, to estimate sample size and ultimately to test the integrity of the research protocol before embarking on the main trial.

Detailed Description

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Conditions

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Prelabour Rupture of Membranes at Term

Keywords

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Prelabour rupture of membranes term pregnancy management vaginal examination induction of labour expectant management

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Expectant management and minimal vaginal examinations

Expectant management up to approximately 96hours and vaginal examinations only when necessary during active labour

Group Type EXPERIMENTAL

Expectant management

Intervention Type PROCEDURE

Minimal Vaginal examinations (only when necessary)

Intervention Type PROCEDURE

Expectant management and routine vaginal examinations

Expectant management up to approximately 96hours and routine vaginal examinations during active labour

Group Type EXPERIMENTAL

Expectant management

Intervention Type PROCEDURE

Routine vaginal examinations

Intervention Type PROCEDURE

Active management and minimal vaginal examinations

Induction of labour at approximately 24hours and vaginal examinations only when necessary during active labour

Group Type EXPERIMENTAL

Minimal Vaginal examinations (only when necessary)

Intervention Type PROCEDURE

Active management

Intervention Type PROCEDURE

Active management and routine vaginal examinations

Induction of labour at approximately 24hours and routine vaginal examinations

Group Type ACTIVE_COMPARATOR

Active management

Intervention Type PROCEDURE

Routine vaginal examinations

Intervention Type PROCEDURE

Interventions

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Expectant management

Intervention Type PROCEDURE

Minimal Vaginal examinations (only when necessary)

Intervention Type PROCEDURE

Active management

Intervention Type PROCEDURE

Routine vaginal examinations

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Prelabour rupture of membranes (confirmed)
* Term pregnancy - from 37+0 till 41+2 weeks gestation (both inclusive)
* Normal/Low risk pregnancy
* Singleton, cephalic pregnancy
* No known current infectious diseases
* Aged 18-45 years old
* Understands English and is able to read and write in English
* Agree for their placentas to be sent to histology if clinical signs of infection
* Not taking part in other clinical research at present
* Consent to take part

Exclusion Criteria

* Pregnancy of 36+6 or less or 41+3 or more weeks gestation
* Breech or oblique presentation
* Twin or multiple pregnancy
* Previous caesarean section
* Meconium stained liquor
* Pre-eclampsia
* Diabetes
* Known to be colonised by Group B streptococcus
* Current infections: HIV, Hepatitis B, Herpes
* Doesn't give consent for the placenta to be sent to histology if clinical signs of infection
* Not able to understand, read or write in English
* Currently taking part in other clinical research
Minimum Eligible Age

18 Years

Maximum Eligible Age

45 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Lancashire Care NHS Foundation Trust

NETWORK

Sponsor Role collaborator

University of Central Lancashire

OTHER

Sponsor Role lead

Responsible Party

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Lucia Ramirez-Montesinos

Miss

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Lucia Ramirez-Montesinos, MSc BSc

Role: PRINCIPAL_INVESTIGATOR

University of Central Lancashire

Soo Downe, PhD MSc BSc

Role: STUDY_DIRECTOR

University of Central Lancashire

Locations

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Lancashire Teaching Hospitals NHS Trust

Preston, Lancashire, United Kingdom

Site Status RECRUITING

Countries

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United Kingdom

Central Contacts

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Lucia Ramirez-Montesinos, MSc BSc

Role: CONTACT

Phone: 00447897236172

Email: [email protected]

Facility Contacts

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Ann Docherty, Research midwife

Role: primary

Other Identifiers

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U1111-1185-3426

Identifier Type: OTHER

Identifier Source: secondary_id

STEMH-503

Identifier Type: -

Identifier Source: org_study_id