Ultrasound Assessment of DILAPAN-S

NCT ID: NCT04529837

Last Updated: 2023-08-09

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

44 participants

Study Classification

OBSERVATIONAL

Study Start Date

2020-10-01

Study Completion Date

2021-06-30

Brief Summary

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The goal of this observational prospective study is to assess the change in Dilapan-S rod diameters using transvaginal ultrasound over a period of 12 hours in term women undergoing induction of labor.

Detailed Description

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On admission for induction, study participants assigned to each group underwent continuous cardiotocography for 20 minutes prior to placement of the Dilapan-S rods (rod size: 4 x 65mm). Placement of the Dilapan-S rods was limited to three physicians with the majority placed by the primary investigator. Placement was completed in a sterile manner under direct visualization and in accordance with the manufacturer's guidelines. The number of rods placed varied per individual and was based on the discretion of the physician. Each participant allocated to the Dilapan-S with saturated gauze group received placement of one, 4x4 inch gauze saturated with 10 cc of normal saline and placed at the level of the external os. Immediately after placement of the Dilapan-S rods, the study participant was asked to complete a patient satisfaction survey.

Pre-specified transvaginal ultrasound assessment was performed at hours 3, 6, 8, and 12 post Dilapan-S placement using a GE Voluson E10 machine with a transvaginal GE RIC 5-9D transducer. Performance of the ultrasound evaluation was limited to the primary investigator and two co-authors of the study. After completion of the 12-hour ultrasound, the Dilapan-S rods and gauze, if used, were removed as per the manufacturer's instructions. The participant was then asked to complete a post Dilapan-S patient satisfaction survey.

Conditions

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Cervical Dilation Induction of Labor Ultrasound Evaluation

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Pregnant individuals with Dilapan-S only

22 women received Dilapan-S rods without gauze at start of induction.

No gauze

Intervention Type OTHER

no gauze

Pregnant individuals with Dilapan-S plus gauze placement

22 women received Dilapan-S rods with 1 gauze at start of induction.

Gauze

Intervention Type OTHER

placement of gauze

Interventions

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Gauze

placement of gauze

Intervention Type OTHER

No gauze

no gauze

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Pregnant individuals at gestational age 37 weeks or greater.
* Scheduled medical or elective induction at Sentara Norfolk General Hospital.
* Live, singleton IUP.
* Vertex presentation.
* Intact membranes.
* Bishop score of 6 or less.

Exclusion Criteria

* Unwilling or unable to provide consent.
* Intrauterine fetal demise
* Contraindications to vaginal delivery.
* BMI \> 45
* Vaginal bleeding
* Clinically evident genital tract infection
Minimum Eligible Age

18 Years

Maximum Eligible Age

45 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Eastern Virginia Medical School

OTHER

Sponsor Role lead

Responsible Party

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Elizabeth Seagraves

Maternal Fetal Medicine Fellow

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Elizabeth Seagraves, DO

Role: PRINCIPAL_INVESTIGATOR

Eastern Virginia Medical School MFM Fellowship

Locations

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Eastern Virginia Medical School

Norfolk, Virginia, United States

Site Status

Countries

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United States

References

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Chen W, Xue J, Peprah MK, Wen SW, Walker M, Gao Y, Tang Y. A systematic review and network meta-analysis comparing the use of Foley catheters, misoprostol, and dinoprostone for cervical ripening in the induction of labour. BJOG. 2016 Feb;123(3):346-54. doi: 10.1111/1471-0528.13456. Epub 2015 Nov 5.

Reference Type BACKGROUND
PMID: 26538408 (View on PubMed)

Grobman WA, Rice MM, Reddy UM, Tita ATN, Silver RM, Mallett G, Hill K, Thom EA, El-Sayed YY, Perez-Delboy A, Rouse DJ, Saade GR, Boggess KA, Chauhan SP, Iams JD, Chien EK, Casey BM, Gibbs RS, Srinivas SK, Swamy GK, Simhan HN, Macones GA; Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Labor Induction versus Expectant Management in Low-Risk Nulliparous Women. N Engl J Med. 2018 Aug 9;379(6):513-523. doi: 10.1056/NEJMoa1800566.

Reference Type BACKGROUND
PMID: 30089070 (View on PubMed)

American College of Obstetricians and Gynecologists. Induction of Labor. ACOG Practice Bulletin No. 107. August 2009.

Reference Type BACKGROUND

Saad AF, Villarreal J, Eid J, Spencer N, Ellis V, Hankins GD, Saade GR. A randomized controlled trial of Dilapan-S vs Foley balloon for preinduction cervical ripening (DILAFOL trial). Am J Obstet Gynecol. 2019 Mar;220(3):275.e1-275.e9. doi: 10.1016/j.ajog.2019.01.008. Epub 2019 Feb 18.

Reference Type BACKGROUND
PMID: 30790569 (View on PubMed)

Drunecky T, Reidingerova M, Plisova M, Dudic M, Gdovinova D, Stoy V. Experimental comparison of properties of natural and synthetic osmotic dilators. Arch Gynecol Obstet. 2015 Aug;292(2):349-54. doi: 10.1007/s00404-015-3623-3. Epub 2015 Jan 25.

Reference Type BACKGROUND
PMID: 25618749 (View on PubMed)

Gupta J, Chodankar R, Baev O, Bahlmann F, Brega E, Gala A, Hellmeyer L, Hruban L, Maier J, Mehta P, Murthy A, Ritter M, Saad A, Shmakov R, Suneja A, Zahumensky J, Gdovinova D. Synthetic osmotic dilators in the induction of labour-An international multicentre observational study. Eur J Obstet Gynecol Reprod Biol. 2018 Oct;229:70-75. doi: 10.1016/j.ejogrb.2018.08.004. Epub 2018 Aug 3.

Reference Type BACKGROUND
PMID: 30107363 (View on PubMed)

Chambers DG, Willcourt RJ, Laver AR, Baird JK, Herbert WY. Comparison of Dilapan-S and laminaria for cervical priming before surgical pregnancy termination at 17-22 weeks' gestation. Int J Womens Health. 2011;3:347-52. doi: 10.2147/IJWH.S25551. Epub 2011 Oct 20.

Reference Type BACKGROUND
PMID: 22114527 (View on PubMed)

Abuhamad, A. Ultrasound in Obstetrics and Gynecology: A Practical Approach. Chapter 1: Basic Physical Principles of Medical Ultrasound. 2014.

Reference Type BACKGROUND

Sung YT, Wu JS. The Visual Analogue Scale for Rating, Ranking and Paired-Comparison (VAS-RRP): A new technique for psychological measurement. Behav Res Methods. 2018 Aug;50(4):1694-1715. doi: 10.3758/s13428-018-1041-8.

Reference Type BACKGROUND
PMID: 29667082 (View on PubMed)

Kliger M, Stahl S, Haddad M, Suzan E, Adler R, Eisenberg E. Measuring the Intensity of Chronic Pain: Are the Visual Analogue Scale and the Verbal Rating Scale Interchangeable? Pain Pract. 2015 Jul;15(6):538-47. doi: 10.1111/papr.12216. Epub 2014 Apr 16.

Reference Type BACKGROUND
PMID: 24735056 (View on PubMed)

Related Links

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https://clear.perinatalquality.org

Cervical Length Education and Review

Other Identifiers

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20-40-FB-0097

Identifier Type: -

Identifier Source: org_study_id

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