Nitric Oxide Donor Isosorbide Mono Nitrate for Cervical Ripening in Induction of Labor

NCT ID: NCT03544606

Last Updated: 2024-08-22

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

PHASE4

Total Enrollment

160 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-12-01

Study Completion Date

2024-06-30

Brief Summary

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The study aims to evaluate and assess the effectiveness and safety of vaginal administration of isosorbide mono nitrate (IMN) to induce cervical ripening and shorten the interval time between induction and delivery in women undergoing induction of labor.

Research Hypothesis:

In women undergoing induction of labor, vaginal administration of isosorbide mono nitrate (IMN) is effective to induce cervical ripening and shorten the interval time between induction and delivery.

Research Questions:

Does vaginal administration of isosorbide mono nitrate (IMN) induce cervical ripening and shorten the interval time between induction and delivery in women undergoing induction of labor?

Detailed Description

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* Type of Study : Prospective double blind randomized controlled clinical trial.
* Study Setting : This study will be conducted in Kafr Elsheikh University maternity hospital.
* Study Period : Expected 6 months from December 2023 to June 2024.
* Study Population : Patients will be recruited in this study those attending labor ward at Kafr Elsheikh hospital for induction of labor at term or post-term with unripe cervix (Bishop Score ˂ 6).

Conditions

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Induction of Labor Affected Fetus / Newborn

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

The patients will be divided into 2 groups.

Group 1:

80 pregnant females, induction of labor will be done by Intra vaginal isosorbide mono nitrate (Effox 40 mg MINAPHARM)

Group 2:

80 pregnant females, induction will be done by placebo (pyridoxine) administered in the posterior vaginal fornix.
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

DOUBLE

Participants Caregivers
To insure that everyone has the chance of participation, Randomization will be done using computer generated randomization sheet using statsdirect version 3. Double blinding will be done by one of the supervisors who will be the only one to know the key, thus the care provider and the patient will not know is it the drug or the placebo.

Study Groups

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isosorbide mononitrate group

In vaginal IMN group (group 1) 40 mg tablet of intra-vaginal IMN (Effox; MINAPHARMA, Cairo, Egypt) will be placed into the posterior fornix of the vagina, through a digital vaginal examination, every 4 h for a maximum of four doses.

Group Type EXPERIMENTAL

isosorbide mononitrate

Intervention Type DRUG

40 mg tablet of intra-vaginal IMN (Effox; MINAPHARMA, Cairo, Egypt) will be placed into the posterior fornix of the vagina, through a digital vaginal examination, every 4 h for a maximum of four doses.

placebos group

In the placebo group (group 2) 40 mg intra-vaginal pyridoxine placebos every 4 h for a maximum of four doses will be given

Group Type PLACEBO_COMPARATOR

Placebos

Intervention Type DRUG

In placebo group (group 2) 40 mg intra-vaginal pyridoxine placebos every 4 h for a maximum of four doses will be given

Interventions

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isosorbide mononitrate

40 mg tablet of intra-vaginal IMN (Effox; MINAPHARMA, Cairo, Egypt) will be placed into the posterior fornix of the vagina, through a digital vaginal examination, every 4 h for a maximum of four doses.

Intervention Type DRUG

Placebos

In placebo group (group 2) 40 mg intra-vaginal pyridoxine placebos every 4 h for a maximum of four doses will be given

Intervention Type DRUG

Other Intervention Names

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Effox 40 mg pyridoxine

Eligibility Criteria

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Inclusion Criteria

* Singleton pregnancy.
* Cephalic presentation.
* Bishop score \< 6.
* Average size of the fetus.
* Adequate pelvic dimensions.
* Term or post-term pregnancies with an indication for labor induction either maternal or fetal.

Exclusion Criteria

* • Previous uterine scar.

* Patients with regular uterine contractions.
* Malpresentation.
* Multifetal gestation.
* Prelabour rupture of membranes.
* Established fetal distress.
* Indication for CS, e.g. Major degree of cephalopelvic disproportion and fetal macrosomia.
* Antepartum hemorrhage.
* Active genital herpes infection.
* Severe maternal illness (e.g. severe preeclampsia).
Minimum Eligible Age

20 Years

Maximum Eligible Age

35 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Kafrelsheikh University

OTHER

Sponsor Role collaborator

ahmed nagy shaker ramadan

OTHER

Sponsor Role lead

Responsible Party

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ahmed nagy shaker ramadan

director

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Ahmed N Shaker, MD

Role: PRINCIPAL_INVESTIGATOR

faculty of medicine - Kafr elsheikh university

Locations

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faculty of medicine - Kafr Elsheikh university

Kafr ash Shaykh, , Egypt

Site Status

Countries

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Egypt

Other Identifiers

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ISMN and labor induction

Identifier Type: -

Identifier Source: org_study_id

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