Management of Prelabor Rupture of the Membranes at Term

NCT ID: NCT04307069

Last Updated: 2024-04-12

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

RECRUITING

Clinical Phase

NA

Total Enrollment

524 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-05-01

Study Completion Date

2024-05-01

Brief Summary

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Prolonged rupture of membranes has been associated with increased risk of chorioamnionitis and endometritis. In this study the investigators will investigate whether an early intervention to augment labor with oxytocin is superior to expected management for spontaneous delivery (up to 24 hours).

Detailed Description

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Prelabor rupture of the membranes (PROM) refers to rupture of the fetal membranes prior to the onset of regular uterine contractions.

PROM at term can be managed actively by induction of labor or expectantly by waiting for the onset of a spontaneous labor. Several studies have shown an association between expectant management and higher rates of maternal and neonatal adverse outcomes, especially infections. Furthermore, expectant management has been shown to increase the risk for cesarean deliveries (CD), chronic lung disease, cerebral palsy and neonatal mortality. It is suggested that the risk for those complications increase proportionally with the longer the duration of ruptured membranes. Others disagree with those associations.

In this study the investigators will investigate whether early administration of oxytocin is superior to expectant management of 24 hours in patients with PROM at term, in terms of time to delivery and maternal and neonatal adverse outcomes, regardless of bishop score.

Conditions

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Fetal Infection Chorioamnionitis Endometritis Cesarean Section Complications

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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Immediate oxytocin infusion

Once the patient will arrive at the maternity ward with prelabor rupture of membranes, she will receive oxytocin for augmentation of labor.

Group Type EXPERIMENTAL

Oxytocin

Intervention Type DRUG

The drug wil be adminisrate for augmentation of labor at admission.

Expectant management for 24 hours

Once the patient will arrive at the maternity ward with prelabor rupture of membranes, we will wait for spontaneous delivery to occur. After 24 hours of rupture of membranes, the woman will receive oxytocin for augmentation of labor.

Group Type EXPERIMENTAL

Oxytocin

Intervention Type DRUG

The drug wil be adminisrate for augmentation of labor at admission.

Interventions

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Oxytocin

The drug wil be adminisrate for augmentation of labor at admission.

Intervention Type DRUG

Other Intervention Names

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pitocin

Eligibility Criteria

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Inclusion Criteria

1. Primiparous women with a singleton pregnancy that are admitted with prelabor rupture of membranes.
2. Women at gestational age 370/7 or more.
3. Vertex presentation.

Exclusion Criteria

1. Age 18 and under.
2. High order gestation.
3. Women with contraindication for a vaginal delivery.
4. Active labor.
5. Documented fetal anomalies.
6. Known or suspected intrauterine infection (temperature \> 38 degrees, leucocytosis).
7. Non reassuring fetal heart rate tracing.
8. Positive group B streptococcus status.
Minimum Eligible Age

18 Years

Maximum Eligible Age

45 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Rambam Health Care Campus

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Gal Bachar, MD

Role: PRINCIPAL_INVESTIGATOR

Rambam Medical Health Center

Locations

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Rambam

Ramat Yishai, , Israel

Site Status RECRUITING

Countries

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Israel

Central Contacts

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Gal Bachar, MD

Role: CONTACT

+972524858699

Facility Contacts

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Gal Bachar

Role: primary

0524858699

Other Identifiers

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Rambam Health-Care Center

Identifier Type: -

Identifier Source: org_study_id

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