Labour Induction With the Propess Vaginal Delivery System vs. Labour Induction With the Prostin Vaginal Tablet in Case of a Prelabour Rupture of Membranes. PESTIBOR Randomized Controlled Trial
试验速览
- 阶段
- 4 期
- 发起方
- 入组人数
- 526
- 主要终点
- Induction to Delivery Interval
研究概览
简要总结
Premature rupture of membranes (PROM) at term is a rupture that occurs at term (> 37 weeks) before the start of labor.
The purpose of the study was to compare the safety and efficacy of two agents used in induction of labor in women with term PROM Propess (Controlled release dinoprostone, Vaginal Delivery System) and Prostin E2 (Dinoprostone vaginal Tablet).
Women will be randomised to two treatment groups.
Although some studies support efficacy of the Propess for cervical ripening at term in induction of labor with intact membranes, it has not been well studied in women with PROM at term.
详细描述
The study is going to include all pregnant women with in-term PROM (after week 37 of pregnancy) without contractions if they meet the inclusion criteria. If the cervix is still non-inducible after 4-6 hours and there are no contractions, the medication to be administered to them will be determined by means of computer randomization. The success rate of induction with Propess vs. Prostin tablets will be compared. Soon after PROM, there can be the onset of contractions and cervix dilation that lead to childbirth.
In case of some pregnant women, there are no contractions and cervix dilation even after the event despite PROM and water breaking. If the status remains unchanged, the risk of intrauterine infection, fetus infection, and later on an infection of the newborn increases. The expecting mother can also eventually lose hope for a successful vaginal birth and starts thinking about having a caesarean delivery. To avoid that, the investigators use medications that accelerate the onset of vaginal birth in clinical practice.
The investigators know several ways to induce labour after PROM. References give no clear and reliable data on the best approach. The investigators can use medications such as oxytocin, dinoprostone, or misoprostol.
Our ward has been using Prostin 3 mg (dinoprostone) vaginal tablets to induce labour in case of PROM for several years. They have proven to be an efficient and safe procedure in our clinical practice.
Propess is used for the induction of labor with intact membranes. Based on the information from references and according to our experience, the medication is highly effective and safe, as well as easy to use.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- Female
- 接受健康志愿者
- 是
入选标准
- •Age 18 years or older
- •Gestational age 37 weeks or more
- •Singleton pregnancy
- •Cephalic presentation
- •Unfavorable cervix (BISHOP <6)
- •No contraindications for vaginal delivery
- •Without uterine surgery
- •Without chorioamnionitis
排除标准
- •Age less than 18 years
- •Multiple gestation
- •Previous cesarean section
- •Suspected intraamniotic infection
- •Any contraindication to vaginal delivery
- •Bishop score >7
- •Pathological ctg
研究组 & 干预措施
Propess Vaginal Delivery System
Propess - Prostaglandin E2 Vaginal Delivery System. Slow intravaginal release of 10 mg dinoprostone at a rate of 0.3 mg/h.
干预措施: Prostaglandin E2 (Propess) (Drug)
Prostin Tablet
Prostaglandin E2 Vaginal Tablet 3 mg dinoprostone
干预措施: Prostaglandin E2 (Prostin) (Drug)
结局指标
主要结局
Induction to Delivery Interval
时间窗: 24 hours
Induction to Onset of labor Interval
时间窗: 24 hours
次要结局
- Frequency of Cesarean Sections(24 hours)
- Frequency of Failed Induction(24 hours)