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Induction of Labour With a Double Balloon Catheter

Completed
Conditions
Labor, Induced
Interventions
Procedure: induction of labour with double balloon catheter placement for 12 hours
Procedure: induction of labour with double balloon catheter placement for 6 hours
Registration Number
NCT05874024
Lead Sponsor
Jena University Hospital
Brief Summary

The objective of this study is to provide a comprehensive analysis of various time intervals (1:1). In addition to evaluating the time interval until delivery after completion of induction, the study also aims to investigate the rate of vaginal births and the type of combination therapy used (including the method of implementation and subsequent induction).

Detailed Description

Approximately 22% of births in Germany are induced annually using either medicinal, mechanical, or sequential mechanical/medicinal methods, with oxytocin and prostaglandins being the available drug options. Double balloon catheters have been used in clinics for over a decade for mechanical induction of labour, resulting in cervical ripening and possible onset of labour through endogenous prostaglandin release. This method is associated with low rates of uterine tachysystole and maternal and neonatal morbidity.

The recommended placement time for the double balloon catheter is 12 hours, typically performed at night in an inpatient setting, which may cause early exhaustion and fatigue for patients. However, a study has shown that a shorter insertion time of 6 hours is equally safe and effective, without any time savings beyond the shortened insertion time.

This study aims to investigate the feasibility and effectiveness of shortening the induction birth interval from 12 to 6 hours. The investigators hypothesize that this will result in a shorter induction birth interval with comparable maternal and neonatal outcomes. This analysis will test the effectiveness of the shortened induction birth interval.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
248
Inclusion Criteria
  • destational age above or equal 37/0 weeks of gestation
  • desired spontanous delivery
  • Bishop-Score below or equal to 5
  • cranial position
  • single pregnancy
Exclusion Criteria
  • unable to consent
  • pathological CTG according FIGO criteria

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Placement 12 hoursinduction of labour with double balloon catheter placement for 12 hoursdouble balloon catheter placement for 12 hours
Placement 6 hoursinduction of labour with double balloon catheter placement for 6 hoursdouble balloon catheter placement for 6 hours
Primary Outcome Measures
NameTimeMethod
induction to delivery intervalFrom date and time of beginning of labour induction to date and time of birth, assessed as long as needed, but not longer than 5 days

the induction to delivery interval measured in minutes

Secondary Outcome Measures
NameTimeMethod
blood loss during deliveryat time of delivery

maternal outcome blood loss during delivery in ml

mode of deliveryafter induction of labour at time of delivery

resulting mode of delivery after induction of labour expressed as spontaneous vaginal, vaginal operative or caesarean section

number of participants with sequential drug induction of labourassessd after double balloon catheter placement until time of birth, but not longer than 3 days

the need for additional drugs for inductionof labour after the assigned placement time of the double balloon catheter

arterial umbilical pHat time of delivery

neonatal outcome arterial umbilical pH measured directly after delivery

number of participants with uterine ruptureat time of delivery

maternal outcome uterine rupture

number of participants with meconium-containing amniotic fluidat time of delivery

neonatal outcome meconium-containing amniotic fluid measured as visible green stained amniotic fluid at time of delivery

prostaglandin to delivery intervalFrom date and time of beginning of prostaglandin treatment to date and time of birth, assessed as long as needed, but not longer than 3 days

the prostaglandin to delivery interval measured in minutes

arterial umbilical base excessat time of delivery

neonatal outcome arterial umbilical base excess measured directly after delivery

number of participants neonatal acidosisat time of delivery

neonatal outcome arterial umbilical pH \< 7.1

number of participants with pathological cardiotocography (CTG)at time of labour induction

neonatal outcome pathological CTG (cardiotocography) at time of labour induction

apgar 5 min5 minutes after delivery

neonatal outcome apgar 5 min (A- appearance, P-Pulse, G- grimace, A- activity, R-respiration) with a range between 0-10 with higher values as better outcome

Trial Locations

Locations (1)

Jena University Hospital

🇩🇪

Jena, Thuringe, Germany

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