Misoprostol for Labour Induction

NCT ID: NCT02904317

Last Updated: 2016-09-16

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

COMPLETED

Total Enrollment

138 participants

Study Classification

OBSERVATIONAL

Study Start Date

2015-08-31

Study Completion Date

2016-01-31

Brief Summary

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Objective: To compare the efficacy and safety of the misoprostol vaginal insert (MVI) with an off-label use of oral misoprostol (OM).

Design: Pair-matched case-control study.

Setting: Tertiary-care academic centre in Germany.

Population: A cohort of 138 women ≥ 37/0 weeks pregnant undergoing labour induction.

Methods: The induction of labour with a retrievable prostaglandin vaginal insert in a consecutive series of 69 women was compared with induction using oral misoprostol in a pair-matched cohort.

Main outcome measures: The primary outcomes were the time from induction to delivery and the caesarean section rate. Secondary outcomes included uterine tachysystole, tocolysis, fetal scalp blood testing, meconium-stained amniotic fluid, umbilical arterial pH, and Apgar score.

Detailed Description

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Open, non-interventional study in a tertiary referral center in Germany N/A The rationale of our observational study is to describe the efficacy and safety profile of the drug with definition of active labor according to local clinical practice in a descriptive observational study in a tertiary referral center.

A time interval from induction of labor to delivery is depending on the duration of the MISODEL® application. By an observational study the investigators want to describe the efficacy and safety with regard to time to delivery and complication rate.

Primary Objective:

The aim of this study is to describe time to vaginal delivery with definition of active labor according to local clinical practice.

The time period needed to induce any delivery and to describe the drug safety profile.

Primary endpoints:

* Time to vaginal delivery in hours in patients with vaginal delivery.
* Length of time until any delivery
* Caesarean section rate
* Time until onset of labor
* Frequency of vaginal operative delivery
* Frequency of abnormal CTG (Figo)
* Frequency of uterine Tachysystole leading to abnormal fetal heartrate i.e. Figo P. Tachysystole is defined as five or more contractions in 10 minutes averaged over three consecutive 10-minute periods.
* Written informed consent of the patients
* ≥18 years of age
* Parity five or less with singleton pregnancies
* ≥36 weeks of gestation
* Unfavourable cervix (baseline modified Bishop score ≤6)

Misoprostol 200mcg VDS is contraindicated according to the SmPC in the following cases:

* When there is hypersensitivity to the active substance or to any of the excipients
* When labour has started
* When oxytocic drugs and/or other labour induction agents are being given
* When there is suspicion or evidence of uterine scar resulting from previous uterine surgery, e.g. C-section
* When there is uterine abnormality (e.g. bicornate uterus)
* When there is placenta praevia or unexplained vaginal bleeding after 24 weeks gestation with this pregnancy
* When there is foetal malpresentation
* When there are signs or symptoms of chorioamnionitis, unless adequate prior treatment has been instituted
* Before week 36 of gestation

For evaluation of the primary and secondary endpoints of the study, descriptive statistical methods will be used.

Conditions

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Labour Induction

Study Design

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Observational Model Type

CASE_CONTROL

Study Groups

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Misprostol vaginal insert for labour induction

69 patients matching the inclusion criteria and received MVI for labour induction

No interventions assigned to this group

Oral misoprostol for labour induction

69 patients matching the inclusion criteria and received OM for labour induction

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* gynaecologist's indication for induction
* informed consent
* \> 37 weeks of gestation
* singleton pregnancies
* cephalic presentation
* cervical Bishop score of \< 5 before priming reassuring fetal heart rate

Exclusion Criteria

* known hypersensitivity to prostaglandins
* uterine scar
* parity \> 5
* any contraindication for vaginal delivery
* cephalopelvic disproportion
* placenta previa
* chorioamnionitis
* antepartum bleeding of unknown aetiology
* cardiopulmonary, renal, hepatic maternal disease glaucoma
* fetal congenital abnormalities
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Asklepios Kliniken Hamburg GmbH

OTHER

Sponsor Role lead

Responsible Party

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Peter Schwaerzler

Principal investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Other Identifiers

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PV4803-2

Identifier Type: -

Identifier Source: org_study_id

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