A Specific Cervicograph for Women Attempting at Vaginal Delivery After Cesarean Section
A Specific Cervicograph for Women Attempting at Vaginal Delivery After Cesarean Section: is the Management of Labor Improved?
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Appropriate management of labor is essential to minimize the risk of uterine rupture in case of attempt at vaginal delivery after a cesarean section (VBAC). Dystocia is a known risk factor for uterine rupture during labor in women with previous cesarean section. Some studies have shown that this risk increases after 2 hours at the same cervical dilation during labor. The cervicograph is an important tool to detect dystocia during labor. There is currently no specific cervicograph for pregnant women with a history of cesarean section, and no study evaluated the cervicograph in the monitoring of labor for women with a scarred uterus.
The main objective is to evaluate a specific cervicograph (the graph describing the cervical dilation, included in the partograph) for pregnant women with an history of cesarean section, to improve the management of labor for women attempting at a vaginal delivery (VBAC). Women will be randomly assigned to a specific cervicograph (including an action line 2 hours after the alert line), or to the normal cervicograph (no lines).
The outcomes of this randomized trial are: appropriate detection and management of dystocia; uterine rupture; and success of VBAC.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Women in labor, admitted for a VBAC at a gestational age of 37 weeks or more
- Single pregnancy
- Cephalic presentation
Exclusion Criteria:
- More than 1 previous cesarean section
- Multiple pregnancies
- Presentations other than cephalic
- History of low vertical uterotomy, classical or inverted T-shaped
- Past history of myomectomy
- Fetal death
- Fetal anomalies
- Placental anomalies
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: specific cervicograph
Specific cervicograph, including an alert line (normal progression of cervical dilation, i.e. 1 cm per hour) and an action line 2 hours after the alert line.
This should be completed after the diagnose of active labor
|
Other Names:
|
|
No Intervention: Usual cervicograph
The usual cervicograph in our unit is not having lines
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Detection of dystocia during labor in women with past history of cesarean section
Time Frame: From inclusion in the study (randomization usually from 2cm) until full cervical dilation.
|
Appropriate detection and management of dystocia by identifying women with: no progression of cervical dilation for more than 2 hours during labor; or slow progress, defined as a cervical dilation of less than 2 cm in 4 hours; and immediate decision of cesarean section, to be performed within 30 minutes.
|
From inclusion in the study (randomization usually from 2cm) until full cervical dilation.
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Uterine rupture during labor in women with past history of cesarean section
Time Frame: From inclusion in the study (randomization usually from 2cm) until delivery
|
Uterine rupture will be defined as a complete separation of the uterine scar that resulted in protrusion of fetal or placental parts in the peritoneal cavity
|
From inclusion in the study (randomization usually from 2cm) until delivery
|
Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Percentage of VBAC
Time Frame: at delivery
|
Percentage of vaginal delivery in women with past history of cesarean section
|
at delivery
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
Other Study ID Numbers
- 12-173 MATPED 12-036
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Attempted Vaginal Delivery After a Cesarean Section
-
NCT01190163TerminatedCesarean Section | Vaginal Delivery
-
NCT02646423CompletedPregnancy | Repeat Cesarean Section | Vaginal Births After Cesarean
-
NCT06103071CompletedVaginal Birth After Cesarean Section
-
NCT04955847RecruitingCesarean Section | Vaginal Delivery | Induction of Labor
-
NCT04053413CompletedScar; Previous Cesarean Section | Decision Making, Shared | Vaginal Birth After Cesarean
-
NCT07212361RecruitingPregnancy | Cesarean Section | Cesarean Delivery Affecting Newborn | Vaginal Delivery | Microbiota | Infant, Newborn | Delivery, Obstetric | Humans | Gut -Microbiota | Neonate
-
NCT03402685CompletedCesarean Section Complications | Cesarean Delivery Affecting Newborn | Cesarean Delivery Affecting Fetus
-
NCT06506721RecruitingCesarean Section | Delivery, Obstetric | Obstetric Delivery
-
NCT07322419RecruitingCesarean Delivery | Spinal Anesthesia for Cesarean Section
-
NCT07567495Not yet recruitingDexmedetomidine | Postoperative Analgesia | Cesarean Delivery | Cesarean Delivery; Neuraxial Opioids | Clonidine | Spinal Anesthesia for Cesarean Section
Clinical Trials on specific cervicograph
-
NCT06875388Active, not recruitingBalance | Cognitive Functioning of Healthy Individuals | Strength, Muscle | Quality of Life (QOL)
-
NCT01778140UnknownRadiographic Contrast Agent Nephropathy
-
NCT03874416RecruitingModerate to Severe Traumatic Brain Injury
-
NCT02883634Completed
-
NCT05049837Recruiting
-
NCT04222478Recruiting
-
NCT07118033Not yet recruitingSub Acute Low Back Pain With Radiating Symptoms
-
NCT05750836Not yet recruitingCaregiver Burden | Oncology
-
NCT00609219Completed