MedPath

Foley Labor Induction Trial at Term and in PROM

Phase 1
Completed
Conditions
Induction of Labor
Interventions
Registration Number
NCT02098421
Lead Sponsor
Icahn School of Medicine at Mount Sinai
Brief Summary

This study is considering current standard oxytocin dosing regimen in combination with Foley bulb for cervical ripening is associated with improved outcomes including greater percentage of women delivered within or less than 24 hours. The investigators will also assess other maternal and neonatal outcomes including risk of infection (i.e. chorioamnionitis), bleeding, uterine atony, cesarean delivery and use of regional analgesia.

Participants will be randomly assigned to one of the 2 arms of the study: use of oxytocin or no oxytocin while the Foley bulb is in place. As part of standard of care for inductions, Foley bulbs will be placed for all participants. Study participants who are randomly assigned to the use of oxytocin will receive oxytocin at the time the Foley bulb is placed. Study participants randomly assigned to no oxytocin will receive the oxytocin once the Foley bulb is removed.

After delivery, information will be collected from participant's chart on the outcome of pregnancy such as gestational age at delivery, type of delivery (vaginal or cesarean section), and baby's outcome (such as birth weight, APGAR scores, and any complications).

Detailed Description

Currently there is a paucity of literature to determine the efficacy of use of Pitocin during Foley placement, a single study has been published which suggests that the induction to delivery time is shortened in multiparas, but not in nulliparas. This study was not specifically powered to assess nulliparas as well, without increased risk.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
312
Inclusion Criteria
  • women at > 24 weeks gestation
  • a non-anomalous, singleton fetus in a vertex presentation
Exclusion Criteria
  • history of prior uterine surgery such as cesarean section or myomectomy
  • unexplained vaginal bleeding
  • latex allergy
  • contraindication to vaginal delivery (i.e. placenta previa, vasa previa, active vaginal bleeding, macrosomia etc)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PROMS Foley and oxytocinOxytocinSubjects who are induced due to premature rupture of membranes randomized to use of Foley bulb and oxytocin once the bulb is removed.
OxytocinOxytocinUse of oxytocin while the Foley bulb is in place
Primary Outcome Measures
NameTimeMethod
induction time to deliveryTime from induction to delivery, average 12-28 hours

The time from induction to delivery will be starting from the time the first induction agent is used on the patient until the official time of birth of the neonate.

Secondary Outcome Measures
NameTimeMethod
uterine atonyaverage of 12-28 hours from induction until official time of birth

uterine atony is assessed by both provider report and/or the use of uterotonics as indicated by the chart.

Mode of deliveryaverage of 12-28 hours from induction until official time of birth

The mode of delivery is ascertained from the delivery summary as either spontaneous vaginal delivery, cesarean delivery, vacuum assisted vaginal delivery, or forcep assisted vaginal delivery.

estimated blood lossaverage of 12-28 hours from induction until official time of birth
neonatal birthweightaverage of 12-28 hours from induction until official time of birth
chorioamnionitisaverage of 12-28 hours from induction until official time of birth

Chorioamnionitis is ascertained from provider report as fever with either maternal/fetal tachycardia, fundal tenderness, or foul smelling fluid while the patient is in labor.

Trial Locations

Locations (2)

Elmhurst Hospital Center

🇺🇸

Elmhurst, New York, United States

Icahn School of Medicine at Mount Sinai

🇺🇸

New York, New York, United States

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