Routine Early vs Delayed Amniotomy for Preterm Pregnancies: A Randomized Open Label Trial

NCT ID: NCT03682822

Last Updated: 2021-05-05

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

TERMINATED

Clinical Phase

NA

Total Enrollment

104 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-11-01

Study Completion Date

2020-02-24

Brief Summary

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To compare the duration of preterm induction of labor in women undergoing early vs. late or no artificial rupture of membranes (AROM). Maternal and neonatal outcomes will also be compared between the two groups.

Detailed Description

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Women presenting with a preterm singleton pregnancy between 28.0 and 36.6 weeks of gestation with cephalic lie and a medical indication for induction of labor will be approached for this study. The patient/provider must be attempting induction with the goal of vaginal delivery. Women with ruptured membranes, suspected intrauterine infection, prior uterine scar, fetal demise, or a fetal anomaly will be excluded. Women that agree to the study will be randomized to 2 groups: the "early amniotomy" group and the "late amniotomy" group.

Women in the early amniotomy group will undergo artificial rupture of membranes (AROM) prior to reaching cervical dilation of 4 cm. Women in the late amniotomy group may not undergo AROM until they reach cervical dilation of greater than 4 cm or they have been on an oxytocin drip for greater than 10 hours with no cervical change. It is possible that a woman in the late amniotomy group will not undergo AROM at all.

The primary outcome under consideration is time in labor. Secondary outcomes include rates of chorioamnionitis, postpartum endometritis, mode of delivery, and neonatal outcomes.

Conditions

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Labor, Premature

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Early artificial rupture of membranes

Women in this arm will undergo artificial rupture of membranes before 4 cm of cervical dilation is reached during induction of labor as long as the procedure is deemed clinically safe and feasible.

Group Type EXPERIMENTAL

Early Artificial rupture of membranes

Intervention Type PROCEDURE

Women in this arm will undergo artificial rupture of membranes before 4 cm of cervical dilation is reached during induction of labor as long as the procedure is deemed clinically safe and feasible.

Delayed artificial rupture of membranes

Women in this arm may undergo artificial rupture of membranes performed only after 4 cm of cervical dilation is reached during induction of labor. Rupture may also be performed after 10 hours of oxytocin administration with no cervical change.

Group Type ACTIVE_COMPARATOR

Delayed Artificial rupture of membranes

Intervention Type PROCEDURE

Women in this arm may undergo artificial rupture of membranes performed only after 4 cm of cervical dilation is reached during induction of labor. Rupture may also be performed after 10 hours of oxytocin administration with no cervical change.

Interventions

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Early Artificial rupture of membranes

Women in this arm will undergo artificial rupture of membranes before 4 cm of cervical dilation is reached during induction of labor as long as the procedure is deemed clinically safe and feasible.

Intervention Type PROCEDURE

Delayed Artificial rupture of membranes

Women in this arm may undergo artificial rupture of membranes performed only after 4 cm of cervical dilation is reached during induction of labor. Rupture may also be performed after 10 hours of oxytocin administration with no cervical change.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Preterm singleton pregnancy between 28.0 and 36.6 completed weeks of gestation
* Fetus in the cephalic position
* Intent to induce labor for vaginal delivery
* If cervical ripening is planned, patient must be enrolled within an hour of initiation of ripening. If no ripening is planned, enrollment must be complete prior to starting induction.

Exclusion Criteria

* Preterm premature rupture of membranes (PPROM)
* Fever or suspected chorioamnionitis prior to start of IOL
* Prior uterine scar
* Infection with HIV/Hepatitis B Virus (HBV)/Hepatitis C Virus (HCV) or an active Herpes Simplex Virus (HSV) infection
* Intrauterine fetal demise
* Major fetal anomaly
* Cervical dilation \> 4 cm
Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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The University of Texas Health Science Center, Houston

OTHER

Sponsor Role lead

Responsible Party

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Clifton O'Neill Brock

Clinical Fellow OBGYN

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Clifton O Brock, MD

Role: PRINCIPAL_INVESTIGATOR

University of Texas Health Science Center of Houston

Locations

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University of Texas Health Science Center of Houston

Houston, Texas, United States

Site Status

Countries

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United States

Other Identifiers

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HSC-MS-18-0511

Identifier Type: -

Identifier Source: org_study_id

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