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Nitric Oxide Donor Isosorbide Mono Nitrate for Cervical Ripening in Induction of Labor

Phase 4
Completed
Conditions
Induction of Labor Affected Fetus / Newborn
Interventions
Registration Number
NCT03544606
Lead Sponsor
ahmed nagy shaker ramadan
Brief Summary

The study aims to evaluate and assess the effectiveness and safety of vaginal administration of isosorbide mono nitrate (IMN) to induce cervical ripening and shorten the interval time between induction and delivery in women undergoing induction of labor.

Research Hypothesis:

In women undergoing induction of labor, vaginal administration of isosorbide mono nitrate (IMN) is effective to induce cervical ripening and shorten the interval time between induction and delivery.

Research Questions:

Does vaginal administration of isosorbide mono nitrate (IMN) induce cervical ripening and shorten the interval time between induction and delivery in women undergoing induction of labor?

Detailed Description

* Type of Study : Prospective double blind randomized controlled clinical trial.

* Study Setting : This study will be conducted in Kafr Elsheikh University maternity hospital.

* Study Period : Expected 6 months from December 2023 to June 2024.

* Study Population : Patients will be recruited in this study those attending labor ward at Kafr Elsheikh hospital for induction of labor at term or post-term with unripe cervix (Bishop Score ˂ 6).

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
160
Inclusion Criteria
  • Singleton pregnancy.
  • Cephalic presentation.
  • Bishop score < 6.
  • Average size of the fetus.
  • Adequate pelvic dimensions.
  • Term or post-term pregnancies with an indication for labor induction either maternal or fetal.
Exclusion Criteria
  • • Previous uterine scar.

    • Patients with regular uterine contractions.
    • Malpresentation.
    • Multifetal gestation.
    • Prelabour rupture of membranes.
    • Established fetal distress.
    • Indication for CS, e.g. Major degree of cephalopelvic disproportion and fetal macrosomia.
    • Antepartum hemorrhage.
    • Active genital herpes infection.
    • Severe maternal illness (e.g. severe preeclampsia).

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
placebos groupPlacebosIn the placebo group (group 2) 40 mg intra-vaginal pyridoxine placebos every 4 h for a maximum of four doses will be given
isosorbide mononitrate groupisosorbide mononitrateIn vaginal IMN group (group 1) 40 mg tablet of intra-vaginal IMN (Effox; MINAPHARMA, Cairo, Egypt) will be placed into the posterior fornix of the vagina, through a digital vaginal examination, every 4 h for a maximum of four doses.
Primary Outcome Measures
NameTimeMethod
admission-delivery intervalup to 24 hours

The time from initiation labor induction and delivery of placenta

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

faculty of medicine - Kafr Elsheikh university

🇪🇬

Kafr Ash Shaykh, Egypt

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