None listed
Conditions
Brief summary
Induction of labor is a common obstetric procedure that is being more widely used nowadays than ever before. Pharmacologic and mechanical methods are used to induce labor. As there are different modes of action, a reduced induction-to-delivery time can be expected if the pharmacologic and mechanical methods are used simultaneously. The hypothesis is that a combination of pharmacological (oral misoprostol) and mechanical dilation (CRB - a double balloon device) improve the efficacy of labor induction. In a primary study the combination showed to be beneficial. These results supposed to be checked in a multicenter trial with different misoprostol regimes.
Interventions
Combination of OM and mechanical dilation with a double-balloon catheter for cervical ripening (COOK CRB) is used. Each participating hospital uses its own misoprostol regime plus CRB for a maximum of 12 hours the first day. e.g. the regime of the primary study unit: First day: OM 50 microg with repeat doses 4 and 8 hours later if necessary plus CRB for a maximum of 12 hours Second day: OM 100 microg with repeat doses 4 and 8 hours later if necessary Third day: misoprostol 50 microg vaginally with repeat doses 4 and 8 hours later if necessary
Sponsors
Study design
Eligibility
Inclusion criteria
singleton pregnancy at term greater than 259 days of gestation, vertex presentation, indication for induction of labor, and an unfavorable cervix (Bishop score < 8)
Exclusion criteria
Premature Rupture of Membranes (PROM), contraindication for labor induction with misoprostol (e.g. placenta previa, previous cesarean sections), cases of structural or chromosomal malformation, intrauterine fetal death.