- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02904317
Misoprostol for Labour Induction
The Misoprostol Vaginal Insert Compared With Oral Misoprostol for Labour Induction in Term Pregnancies: a Pair-matched Case-control Study
Objective: To compare the efficacy and safety of the misoprostol vaginal insert (MVI) with an off-label use of oral misoprostol (OM).
Design: Pair-matched case-control study.
Setting: Tertiary-care academic centre in Germany.
Population: A cohort of 138 women ≥ 37/0 weeks pregnant undergoing labour induction.
Methods: The induction of labour with a retrievable prostaglandin vaginal insert in a consecutive series of 69 women was compared with induction using oral misoprostol in a pair-matched cohort.
Main outcome measures: The primary outcomes were the time from induction to delivery and the caesarean section rate. Secondary outcomes included uterine tachysystole, tocolysis, fetal scalp blood testing, meconium-stained amniotic fluid, umbilical arterial pH, and Apgar score.
Study Overview
Status
Conditions
Detailed Description
Open, non-interventional study in a tertiary referral center in Germany N/A The rationale of our observational study is to describe the efficacy and safety profile of the drug with definition of active labor according to local clinical practice in a descriptive observational study in a tertiary referral center.
A time interval from induction of labor to delivery is depending on the duration of the MISODEL® application. By an observational study the investigators want to describe the efficacy and safety with regard to time to delivery and complication rate.
Primary Objective:
The aim of this study is to describe time to vaginal delivery with definition of active labor according to local clinical practice.
The time period needed to induce any delivery and to describe the drug safety profile.
Primary endpoints:
- Time to vaginal delivery in hours in patients with vaginal delivery.
- Length of time until any delivery
- Caesarean section rate
- Time until onset of labor
- Frequency of vaginal operative delivery
- Frequency of abnormal CTG (Figo)
- Frequency of uterine Tachysystole leading to abnormal fetal heartrate i.e. Figo P. Tachysystole is defined as five or more contractions in 10 minutes averaged over three consecutive 10-minute periods.
- Written informed consent of the patients
- ≥18 years of age
- Parity five or less with singleton pregnancies
- ≥36 weeks of gestation
- Unfavourable cervix (baseline modified Bishop score ≤6)
Misoprostol 200mcg VDS is contraindicated according to the SmPC in the following cases:
- When there is hypersensitivity to the active substance or to any of the excipients
- When labour has started
- When oxytocic drugs and/or other labour induction agents are being given
- When there is suspicion or evidence of uterine scar resulting from previous uterine surgery, e.g. C-section
- When there is uterine abnormality (e.g. bicornate uterus)
- When there is placenta praevia or unexplained vaginal bleeding after 24 weeks gestation with this pregnancy
- When there is foetal malpresentation
- When there are signs or symptoms of chorioamnionitis, unless adequate prior treatment has been instituted
- Before week 36 of gestation
For evaluation of the primary and secondary endpoints of the study, descriptive statistical methods will be used.
Study Type
Enrollment (Actual)
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- gynaecologist's indication for induction
- informed consent
- > 37 weeks of gestation
- singleton pregnancies
- cephalic presentation
- cervical Bishop score of < 5 before priming reassuring fetal heart rate
Exclusion Criteria:
- known hypersensitivity to prostaglandins
- uterine scar
- parity > 5
- any contraindication for vaginal delivery
- cephalopelvic disproportion
- placenta previa
- chorioamnionitis
- antepartum bleeding of unknown aetiology
- cardiopulmonary, renal, hepatic maternal disease glaucoma
- fetal congenital abnormalities
Study Plan
How is the study designed?
Design Details
- Observational Models: Case-Control
Cohorts and Interventions
Group / Cohort |
---|
Misprostol vaginal insert for labour induction
69 patients matching the inclusion criteria and received MVI for labour induction
|
Oral misoprostol for labour induction
69 patients matching the inclusion criteria and received OM for labour induction
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
time from application of the medication until delivery in minutes
Time Frame: September 2015
|
September 2015
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Rate of participants receiving a caesarean section compared to all participants being induced
Time Frame: September 2015
|
September 2015
|
Number of participants with treatment-related tachysystole as assessed by cardiotocography
Time Frame: September 2015
|
September 2015
|
Number of participants with treatment-related adverse events following tocolysis with Partusisten
Time Frame: September 2015
|
September 2015
|
Number of participants with fetal compromise assessed by the APGAR-Score and the postpartum fetal pH-value
Time Frame: September 2015
|
September 2015
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
- PV4803-2
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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