- ICH GCP
- USA klinikai vizsgálatok nyilvántartása
- Klinikai vizsgálat NCT07935681
Foley Catheter vs. Foley + Extra-amniotic Saline Infusion for Labor Induction at 41 Weeks and Beyond (FEASI)
The Effect of Foley Catheter Versus Foley Plus Extra-amniotic Saline Infusion on Bishop Progression, Labor Parameters, and Perinatal Outcomes in Pregnancies at 41 Weeks and Beyond: A Randomized Controlled Trial"
This study is a prospective, randomized controlled trial conducted at Ankara Bilkent City Hospital to compare two mechanical methods for labor induction in post-term pregnancies. The research evaluates the efficacy and safety of a Foley catheter alone versus a Foley catheter combined with extra-amniotic saline infusion (EASI). The study specifically targets primiparous women with a gestational age greater than or equal to 41+0 weeks and an unfavorable cervix, defined as an initial Bishop score less than or equal to 6. The primary objective is to determine the change in the Bishop score within the first 6 hours to identify which method more effectively promotes cervical ripening and successful labor induction.
A tanulmány áttekintése
Állapot
Körülmények
Részletes leírás
Background and Rationale: Labor induction is the artificial initiation of contractions before spontaneous labor to achieve vaginal delivery. Mechanical methods, such as the Foley catheter, induce cervical ripening by creating physical pressure and stimulating the local release of prostaglandins. This study aims to provide evidence-based data on whether the addition of a continuous saline infusion (EASI) to the Foley catheter results in shorter labor durations and higher vaginal delivery rates compared to the catheter alone.
Study Design and Population:
- Design: A prospective, 1:1 randomized controlled clinical trial.
- Setting: All procedures are conducted under standardized aseptic conditions by trained operators in the delivery unit of Ankara Bilkent City Hospital.
- Sample Size: Based on a power analysis with an effect size of $d = 0.80$, a total of 60 to 64 participants (30 to 32 per group) will be enrolled to account for potential data loss.
Inclusion and Exclusion Criteria:
- Inclusion: Primiparous women , gestational age greater than or equal to 41+0 weeks , singleton pregnancy in cephalic presentation , reactive non-stress test (NST) with a biophysical profile greater than or equal to 8/10 , and a Bishop score less than or equal to 6.
- Exclusion: Multiple pregnancies , ruptured membranes , previous uterine surgery (e.g., Cesarean section) , placenta previa , fetal growth restriction (IUGR) , or high-risk systemic diseases such as severe heart disease or diabetes.
Study Procedures and Monitoring: Participants are randomly assigned to either the Foley group or the Foley+EASI group. Labor progress is monitored according to standard obstetric protocols. The study monitors several parameters, including the time from induction to active labor, total delivery time, and the mode of delivery.
Outcome Measures:
- Primary Outcome: Change in the Bishop score recorded 6 hours after induction.
- Secondary Outcomes: Vaginal delivery rate within 24 hours , Cesarean section rates and indications , maternal infection indicators such as fever greater than or equal to 38°C or chorioamnionitis , and neonatal outcomes including Apgar scores and birth weight.
Statistical Analysis: Data will be analyzed using descriptive statistics. Continuous variables will be compared using the Student's t-test or Mann-Whitney U test , while categorical variables will be evaluated using the Chi-square or Fisher's exact test. A p-value less than 0.05 will be considered statistically significant.
Tanulmány típusa
Beiratkozás (Becsült)
Fázis
- Nem alkalmazható
Kapcsolatok és helyek
Tanulmányi kapcsolat
- Név: AYŞENUR TÜRE, M.D
- Telefonszám: +905377871445
- E-mail: draysenuryeniceri@gmail.com
Tanulmányi helyek
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ÇANKAYA
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Ankara, ÇANKAYA, Törökország (Türkiye)
- Toborzás
- Bilkent City Hospital
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Kapcsolatba lépni:
- AYŞENUR TÜRE
- Telefonszám: 05377871445
- E-mail: draysenuryeniceri@gmail.com
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Részvételi kritériumok
Jogosultsági kritériumok
Tanulmányozható életkorok
Egészséges önkénteseket fogad
Tanulmányozható nemek
Leírás
Inclusion Criteria:
Primiparous women (First-time mothers).
Gestational age greater than or equal to 41+0 weeks.
Singleton pregnancy in cephalic presentation.
Unfavorable cervix, defined as a Bishop score less than or equal to 6.
Reactive Non-Stress Test (NST) and a biophysical profile score greater than or equal to 8/10.
Aged greater than or equal to 18 years.
Willingness to provide written informed consent. -
Exclusion Criteria:
Multiple pregnancies (e.g., twins, triplets).
Previous uterine surgery (e.g., prior Cesarean section or myomectomy).
Premature Rupture of Membranes (PROM).
Presence of placenta previa or vasa previa.
Fetal growth restriction (IUGR).
Active genital herpes infection.
Known hypersensitivity to the materials used (e.g., latex allergy if applicable).
Serious maternal systemic diseases (e.g., severe heart disease, uncontrolled diabetes, or preeclampsia).
Fetal anomalies or non-reassuring fetal heart rate patterns.
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Tanulási terv
Hogyan készül a tanulmány?
Tervezési részletek
- Elsődleges cél: Kezelés
- Kiosztás: Véletlenszerűsített
- Beavatkozó modell: Párhuzamos hozzárendelés
- Maszkolás: Nincs (Open Label)
Fegyverek és beavatkozások
Résztvevő csoport / kar |
Beavatkozás / kezelés |
|---|---|
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Kísérleti: Foley Catheter + EASI
"Participants in this arm will receive a single-balloon Foley catheter (16-18 French) inserted into the extra-amniotic space through the internal os of the cervix. The balloon will be inflated with 30-50 ml of sterile saline. Additionally, a continuous extra-amniotic saline infusion (EASI) will be administered at a rate of 30 ml/hour to enhance cervical ripening." |
A single-balloon Foley catheter (16-18 French) is inserted through the internal os of the cervix into the extra-amniotic space under aseptic conditions. The balloon is inflated with 30-50 ml of sterile saline. Following placement, a continuous extra-amniotic saline infusion (EASI) is administered through the catheter at a constant rate of 30 ml per hour using an infusion pump. The procedure aims to induce cervical ripening through both mechanical pressure and biochemical stimulation.
Más nevek:
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Aktív összehasonlító: Foley Catheter Alone
Participants in this arm will receive a single-balloon Foley catheter (16-18 French) inserted into the extra-amniotic space through the internal os of the cervix. The balloon will be inflated with 30-50 ml of sterile saline. No additional saline infusion will be administered. This group serves as the standard mechanical induction control." |
A single-balloon Foley catheter (16-18 French) is inserted through the internal os of the cervix into the extra-amniotic space under aseptic conditions. The balloon is inflated with 30-50 ml of sterile saline. The catheter is then taped to the inner thigh of the patient to maintain tension. No saline infusion is administered in this group. The catheter remains in place until spontaneous expulsion or for a maximum duration of 12 hours.
Más nevek:
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Mit mér a tanulmány?
Elsődleges eredményintézkedések
Eredménymérő |
Intézkedés leírása |
Időkeret |
|---|---|---|
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Change in Bishop Score (ΔBishop)
Időkeret: From baseline (0 hour) to 6 hours after catheter insertion
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The Bishop score is a pre-labor scoring system to assist in predicting whether induction of labor will be required. The score (ranging from 0 to 13) evaluates cervical dilation, effacement, consistency, position, and fetal station. This measure represents the numerical increase in the score after 6 hours of induction. |
From baseline (0 hour) to 6 hours after catheter insertion
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Másodlagos eredményintézkedések
Eredménymérő |
Intézkedés leírása |
Időkeret |
|---|---|---|
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Rate of Vaginal Delivery within 24 Hours
Időkeret: Within 24 hours of induction initiation
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The percentage of participants who achieved a successful vaginal delivery within the first 24 hours |
Within 24 hours of induction initiation
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Total Induction to Delivery Duration
Időkeret: From the start of catheter insertion until the birth of the neonate (typically up to 48 hours).
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The total time elapsed (in hours) from the beginning of the induction procedure to the actual delivery |
From the start of catheter insertion until the birth of the neonate (typically up to 48 hours).
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Neonatal Apgar Scores
Időkeret: At 1 minute and 5 minutes after birth.
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Evaluation of the newborn's physical condition using the Apgar scoring system (0-10 scale). |
At 1 minute and 5 minutes after birth.
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Együttműködők és nyomozók
Szponzor
Publikációk és hasznos linkek
Általános kiadványok
- Karjane NW, Brock EL, Walsh SW. Induction of labor using a foley balloon, with and without extra-amniotic saline infusion. Obstet Gynecol. 2006 Feb;107(2 Pt 1):234-9. doi: 10.1097/01.AOG.0000198629.44186.c8.
- Abramovici D, Goldwasser S, Mabie BC, Mercer BM, Goldwasser R, Sibai BM. A randomized comparison of oral misoprostol versus Foley catheter and oxytocin for induction of labor at term. Am J Obstet Gynecol. 1999 Nov;181(5 Pt 1):1108-12. doi: 10.1016/s0002-9378(99)70090-6.
- Vaknin Z, Kurzweil Y, Sherman D. Foley catheter balloon vs locally applied prostaglandins for cervical ripening and labor induction: a systematic review and metaanalysis. Am J Obstet Gynecol. 2010 Nov;203(5):418-29. doi: 10.1016/j.ajog.2010.04.038.
Tanulmányi rekorddátumok
Tanulmány főbb dátumok
Tanulmány kezdete (Tényleges)
Elsődleges befejezés (Becsült)
A tanulmány befejezése (Becsült)
Tanulmányi regisztráció dátumai
Először benyújtva
Először nyújtották be, amely megfelel a minőségbiztosítási kritériumoknak
Első közzététel (Tényleges)
Tanulmányi rekordok frissítései
Utolsó frissítés közzétéve (Tényleges)
Az utolsó frissítés elküldve, amely megfelel a minőségbiztosítási kritériumoknak
Utolsó ellenőrzés
Több információ
A tanulmányhoz kapcsolódó kifejezések
Kulcsszavak
További vonatkozó MeSH feltételek
Egyéb vizsgálati azonosító számok
- TABED 2-25-1766
Terv az egyéni résztvevői adatokhoz (IPD)
Tervezi megosztani az egyéni résztvevői adatokat (IPD)?
IPD terv leírása
There is no plan to share individual participant data. The study results will be published in aggregate form in a peer-reviewed journal
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