MedPath

IV PAPAVERINE Prior to Propess for Labor Induction

Phase 4
Completed
Conditions
Induced Vaginal Delivery
Interventions
Other: placebo
Registration Number
NCT06550232
Lead Sponsor
Western Galilee Hospital-Nahariya
Brief Summary

The investigators aim to evaluate the effect of administering papaverine prior to PGE2 insertion on changes in Bishop-scores and on the induction-to-delivery interval.

Researchers will compare drug papaverine to a placebo

Detailed Description

More than 22% of all pregnant women undergo induction of labor. Induction of labor is usually medically indicated for maternal and fetal related conditions; however, elective induction has become more common since the ARRIVE trial. Women with an unfavourable cervix, according to Bishop-score (\<6), are prone to higher induction failure rates and are candidates for cervical ripening.

The cervix is composed of connective tissue and smooth-muscle located mainly beneath the internal os. Papaverine is an antispasmodic-musculotropic drug that targets smooth-muscle, resulting in decreased muscle spasm and subsequent smooth-muscle relaxation. The half-life of the drug is in the range of 0.5-2 hours, and its action starts 10 minutes after administration. Short-term use of papaverine during the first trimester has been reported as safe. However, outcome data are lacking of the use of mucosotropic-agents prior to PGE2 (propess) insertion. We will investigate this in a trial in which the co-primary outcomes were the change in Bishop-score after PGE2 extraction and the PGE2 insertion-to-delivery interval

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
110
Inclusion Criteria
  • singleton term pregnancy
  • bishop score
  • need for labor induction with PGE2
  • vertex presentation
  • viable fetus
Exclusion Criteria
  • Prelabour rupture of membrane
  • Twins pregnancy
  • previous cesarean section
  • allergy to the study medication
  • fetal anomaly contraindications for vaginal delivery
  • maternal supraventricular tachicardia

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Control armplaceboI.V 100 ml 0.9% saline
papaverine armPapaverineIV-papaverine 80 mg in 100 ml 0.9% saline, once
Primary Outcome Measures
NameTimeMethod
the time from propess insertion until delivery72 hours

induction to delivery time

Delta Bishop score24 hours

The bishop score before and after propess insertion

Secondary Outcome Measures
NameTimeMethod
maternal satisfaction scores24 hours

maternal satisfaction on 1-5 scale. higher scores mean higher satisfaction

visual analogue scale score24 hours

pain assessment using a 10-point visual analogue scale

Trial Locations

Locations (1)

Galilee Medical Center

🇮🇱

Nahariyya, Israel

Galilee Medical Center
🇮🇱Nahariyya, Israel

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