Comparative Study Between Only Vaginal Misoprostol and Vaginal Misoprostol and Estradiol Cream

NCT ID: NCT05306405

Last Updated: 2022-04-01

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

UNKNOWN

Clinical Phase

PHASE1/PHASE2

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-02-20

Study Completion Date

2022-08-30

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

To compare the safety and effectiveness of vaginal misoprostol with combined vaginal misoprostol and estradiol for induction of labour in unfavorable cervix

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Induction of labour (IOL) is the process of initiating contractions of pregnant persons who are currently not in labour, to help them achieve vaginal delivery within 24 to 48 hours. Cervical ripening is one of the methods that used for labour induction; it is "the use of pharmacological or other means to soften, efface, or dilate the cervix to increase the likelihood of a vaginal delivery". The two major techniques for cervical ripening are mechanical interventions (e.g. insertion of balloon catheters), and application of pharmacological agents (e.g. prostaglandins). Prostaglandins are one of the preferred methods for cervical ripening, including the agents dinoprostone and misoprostol

. By the mid of-1980s prostaglandins had become established as the most effective pharmacological agents for inducing labour when the cervix is unripped. The vaginal route was found to be the most acceptable, providing good efficacy and acceptability for the parturient and it is the preferred choice now.

During the past 15 years the introduction of misoprostol, the prostaglandinsE1(PGE1) which, unlike prostglandinsE2 (PGE2), is stable at room temperature and it is effective if it was taken orally, has been the major focus of attention for labour induction. It is also considerably cheaper than the alternative prostaglandin.

With the ever-increasing concentrations of estrogen in the maternal circulation leading to term pregnancy, the belief that this could be a trigger for the onset of spontaneous labour led the studies to explore estrogens for the induction of labour.

Estradiol gel gives extra--amniotic, endocervical or vaginally or estradiol intramuscularly and estradiol gel extra-amniotic have been shown to produce some improved cervical favorability with minimal myometrial stimulation.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Cervix; Pregnancy

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

vaginal misoprostol

only vaginal misoprostol 25 μg tablets will be applied for induction of laour

Group Type ACTIVE_COMPARATOR

Vaginal Tablet

Intervention Type DRUG

Misoprostol alone will be repeated every 4 h in both groups for a maximum of 5 doses, reaching Bishop score \>8, rupture of membranes or occurrence of labor pain.

Cervical evaluation will be done using Bishop's score. A score \< 5 will be taken as unfavorable Cervix will be termed as ripped when Bishop's score equal 8 or more.

The endpoint of the study will be initiation of active phase of 1st stage of labor which commence from 6cm to full cervical dilatation

combined vaginal misoprostol and estradiol

vaginal misoprostol 25 μg (Vagiprost) tablets with vaginal estradiol 150 ml cream will be applied for induction of laour

Group Type ACTIVE_COMPARATOR

Vaginal Tablet

Intervention Type DRUG

Misoprostol alone will be repeated every 4 h in both groups for a maximum of 5 doses, reaching Bishop score \>8, rupture of membranes or occurrence of labor pain.

Cervical evaluation will be done using Bishop's score. A score \< 5 will be taken as unfavorable Cervix will be termed as ripped when Bishop's score equal 8 or more.

The endpoint of the study will be initiation of active phase of 1st stage of labor which commence from 6cm to full cervical dilatation

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Vaginal Tablet

Misoprostol alone will be repeated every 4 h in both groups for a maximum of 5 doses, reaching Bishop score \>8, rupture of membranes or occurrence of labor pain.

Cervical evaluation will be done using Bishop's score. A score \< 5 will be taken as unfavorable Cervix will be termed as ripped when Bishop's score equal 8 or more.

The endpoint of the study will be initiation of active phase of 1st stage of labor which commence from 6cm to full cervical dilatation

Intervention Type DRUG

Other Intervention Names

Discover alternative or legacy names that may be used to describe the listed interventions across different sources.

vaginal misoprostol and vaginal estradiol

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Gestational age36:41 weeks.
* Singleton pregnancy.
* Absence of labour pain.
* Living fetus with cephalic presentation.
* Fetal weight \< 4 k.gs.
* No previous uterine surgical procedures.
* No liquor abnormalities.
* Bishop score \< 5.

Exclusion Criteria

* \- Multiple gestations. one of the contraindications of induction of labor as it may cause rupture of the uterus.
* Liquor abnormalities.one of contraindications of induction of labor as it may cause fetal distress.
* Abnormal umbilical artery Doppler indices or non-stress test as these indicate fetal distress.
* Fetal weight \> 4 kgs.as macrosomia is an indication of caesarean section for fear of shoulder dystocia .
* Previous uterine surgery.contraindication of labor induction for fear of rupture uterus.
* Asthmatic patient or women with allergy to prostaglandins or steroidal.
* Non-vertex presentation.contraindication of labor induction as it may cause rupture uterus.
* Fetal or maternal complications that might cause cesarean section.
* Intrauterine fetal death.often induction of labor in women with a dead fetus is performed before term when the uterus may be less responsive to uterotonics than it is at term and this will affect the results of the study
Minimum Eligible Age

20 Years

Maximum Eligible Age

39 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Ain Shams University

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Amira Maher

Resident of Obstetrics and Gynecology at Al-Delengat General Hospital

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Ain Shams University

Cairo, , Egypt

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

Egypt

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Amira M Ahmed, MSC

Role: CONTACT

+201090904528

Rania G Anwar, Lecturer

Role: CONTACT

+2012832627054

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

.Fekria A Salama, Professor

Role: primary

+201092934978

Mortada S Ahmed, Professor

Role: backup

+201001267054

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

001

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.