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Failure of Vaginal Delivery After Induction

Phase 3
Completed
Conditions
Labor Pain
Interventions
Device: foley's balloon catheter
Registration Number
NCT02758340
Lead Sponsor
Karachi Medical and Dental College
Brief Summary

The study will compare the number of women who deliver vaginally after artificial initiation of labor pains(i.e. induction of labor) by two methods. Half of the women would receive tablet misoprostol vaginally and the other half would receive tablet misoprostol and foley's balloon catheter both.

Detailed Description

Artificial initiation of labor pains has become a common occurrence. A variety of methods are employed to initiate labor pains. Labor pains are more successful in culminating into vaginal delivery if the neck of womb that is the cervix is soft (ripe). This is usually achieved by ripening agents. They include drugs and devices that help soften the cervix. Misoprostol and foley's balloon catheter both are used to soften the cervix so that vaginal delivery is possible. Both work on different aspects of the softening of cervix.

Misoprostol acts on shortening the cervix and making it more pliable Foley's balloon helps to open up the cervix that is it aids in dilating the cervical canal.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
335
Inclusion Criteria
  • Gestational age > 37 weeks assessed by Last Menstrual Period and dating scan.
  • Women with singleton pregnancy assessed by ultrasound.
  • Fetus in vertex presentation assessed by ultrasound.
  • Age 20-40 years.
  • Bishop score <4.
Exclusion Criteria
  • Non-consenting.
  • Gestational age < 37 weeks.
  • Patients with history of placenta previa.
  • Patients with history of placental abruption.
  • Ruptured membranes.
  • Patients with history of vaginal infection.
  • Patients with history of congenital anomalies in previous deliveries.
  • Patients with history of stroke, renal impairment and chronic obstructive pulmonary disease, chronic liver disease and congestive cardiac failure

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
M=misoprostolMisoprostolPatients who would receive Only oral misoprostol{(50 micrograms) tab cytotec ¼ tablets (Searle)}. All patients in this group will be given oral misoprostol 50 μg per dose. The dose will be repeated at 4 hours interval up to a maximum of 4 doses till labor is induced (3 contractions per 10 minutes). If labor is not established within 4 hours of the administration of the fourth dose, induction will be considered to be failed
M+F=MISOPROSTOL+FOLEY'S BALLOON CATHETERMisoprostolAll patients in this group will be explained the technique of foley's catheter ballooning and informed consent will be taken. The cervix will be visualized with the help of Cusco's speculum. The balloon will be inflated with about 30 cc of sterile water. The catheter will be pulled down to bring the balloon into the cervical canal and will be tapped around the thigh. Patients will also be given oral misoprostol 50 μg per dose. The dose will be repeated at 4 hours interval up to a maximum of 4 doses till labor is induced (3 contractions per 10 minutes).
M+F=MISOPROSTOL+FOLEY'S BALLOON CATHETERfoley's balloon catheterAll patients in this group will be explained the technique of foley's catheter ballooning and informed consent will be taken. The cervix will be visualized with the help of Cusco's speculum. The balloon will be inflated with about 30 cc of sterile water. The catheter will be pulled down to bring the balloon into the cervical canal and will be tapped around the thigh. Patients will also be given oral misoprostol 50 μg per dose. The dose will be repeated at 4 hours interval up to a maximum of 4 doses till labor is induced (3 contractions per 10 minutes).
Primary Outcome Measures
NameTimeMethod
failure of vaginal delivery i.e.percentage of women in both groups who would fail to deliver vaginally after 24 hours of induction.six months
Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Abbasi shaheed hospital

🇵🇰

Karachi, Sindh, Pakistan

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