Nitroglycerin Skin Patches for Facilitating Cervical Ripening: A Randomized Controlled Trial

NCT ID: NCT03320187

Last Updated: 2017-10-25

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

PHASE2/PHASE3

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-12-31

Study Completion Date

2017-09-21

Brief Summary

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This study aims to establish the efficacy of transdermal glyceryl trinitrate as a nitric oxide donor in addition to dinoprostone for induction of cervical ripening in the third trimester through progression in the Bishop's score during 24 hour period.

Detailed Description

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Objectives: The primary outcome of the study is to compare the changes occurring to the cervix through the progression in the Bishop's score between NO donor (nitroglycerine patch) vs placebo; in combination with a well-established method of induction (Dinoprostone).

The secondary objective of the study is to observe and report possible fetal and maternal side effects that may be associated. This will establish the safety and tolerability of NO donors.

Research Question: Does the usage of Nitroglycerine skin patch enhance cervical ripening and facilitate induction of labor by Dinoprostone?

Null hypothesis: Nitroglycerine skin patch does not cause advantage for ripening of the cervix nor facilitate the process of labor induction.

Alternative hypothesis : Nitroglycerine skin patch has favorable effect in enhancing cervical ripening and the outcome of induction of labor.

Conditions

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Induction of Labor Affected Fetus / Newborn

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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Group A

Nitroglycerin as Nitroderm TTSⓇ skin patch is applied on the upper chest alongside with regular induction of labor protocol ( 3gm/ 8 hours DinoprostoneⓇ vaginal tablet in the posterior vaginal fornix)

Group Type EXPERIMENTAL

Nitroderm TTS

Intervention Type DRUG

Transdermal nitroglycerin 5mg skin patch

Dinoprostone

Intervention Type DRUG

Dinoprostone 3gm vaginal tablet will be used as the study method of labor induction

Group B

Placebo patch is applied on the upper chest alongside with regular induction of labour protocol ( 3gm/ 8 hours DinoprostoneⓇ vaginal tablet in the posterior vaginal fornix)

Group Type PLACEBO_COMPARATOR

Dinoprostone

Intervention Type DRUG

Dinoprostone 3gm vaginal tablet will be used as the study method of labor induction

Interventions

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Nitroderm TTS

Transdermal nitroglycerin 5mg skin patch

Intervention Type DRUG

Dinoprostone

Dinoprostone 3gm vaginal tablet will be used as the study method of labor induction

Intervention Type DRUG

Other Intervention Names

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Nitroglycerin transdermal patch Prostaglandin E2 Analogue

Eligibility Criteria

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Inclusion Criteria

1. Singleton living full-term fetus.
2. Cephalic presentation,
3. Bishop score less than 5,
4. Assuring fetal monitoring,
5. The mother does not have PROM,

Exclusion Criteria

1. Expected fetal anomaly (eg. by ultrasound),
2. Abnormal presentation,
3. Multiple pregnancy,
4. Non assuring fetal CTG,
5. Fetus more than 90th percentile of expected weight,
6. Previous maternal obstructed labor or previous cesarean section,
7. Maternal obstetric or medical complication,
8. Structural anomaly of the uterus
Minimum Eligible Age

17 Years

Maximum Eligible Age

35 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Dr. Ahmed S. Abd El-Hameed

UNKNOWN

Sponsor Role collaborator

Prof. Abdel-Megeeed I. Abdel- Megeeed

UNKNOWN

Sponsor Role collaborator

Ain Shams Maternity Hospital

OTHER

Sponsor Role lead

Responsible Party

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Peter Nagy Aziz Hanna

Resident Physician

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Prof. Abdel-Megeeed I. Abdel-Megeeed, Doctorate

Role: STUDY_CHAIR

Ain Shams University Maternity Hospital

Ahmed S. Abd El-Hamid, Doctorate

Role: STUDY_DIRECTOR

Ain Shams University Maternity Hospital

Locations

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AinShams University Maternity Hospital

Cairo, , Egypt

Site Status

Countries

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Egypt

References

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Sharma Y, Kumar S, Mittal S, Misra R, Dadhwal V. Evaluation of glyceryl trinitrate, misoprostol, and prostaglandin E2 gel for preinduction cervical ripening in term pregnancy. J Obstet Gynaecol Res. 2005 Jun;31(3):210-5. doi: 10.1111/j.1447-0756.2005.00271.x.

Reference Type RESULT
PMID: 15916656 (View on PubMed)

Nunes FP, Campos AP, Pedroso SR, Leite CF, Avillez TP, Rodrigues RD, Meirinho M. Intravaginal glyceryl trinitrate and dinoprostone for cervical ripening and induction of labor. Am J Obstet Gynecol. 2006 Apr;194(4):1022-6. doi: 10.1016/j.ajog.2005.10.814.

Reference Type RESULT
PMID: 16580291 (View on PubMed)

West HM, Jozwiak M, Dodd JM. Methods of term labour induction for women with a previous caesarean section. Cochrane Database Syst Rev. 2017 Jun 9;6(6):CD009792. doi: 10.1002/14651858.CD009792.pub3.

Reference Type RESULT
PMID: 28599068 (View on PubMed)

Kelly AJ, Munson C, Minden L. Nitric oxide donors for cervical ripening and induction of labour. Cochrane Database Syst Rev. 2011 Jun 15;(6):CD006901. doi: 10.1002/14651858.CD006901.pub2.

Reference Type RESULT
PMID: 21678363 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

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OG MS27042017

Identifier Type: -

Identifier Source: org_study_id