Labour, Induced
Conditions
Keywords
Labour, induced, Misoprostol, Pharmacokinetics, Cardiotocography, Safety
Brief summary
The purpose of this study is to compare pharmacokinetics of two formulations of misoprostol following single dose administration in adult women being given misoprostol for cervical ripening and induction of labour.
Detailed description
Prostaglandin E2 (dinoprostone) given vaginally or intra-cervically, and oxytocin have been the most commonly used preparations for induction of labour. Misoprostol is a synthetic prostaglandin E1 analogue. Misoprostol has anti-secretory and mucosal protective properties and was originally developed in the 1970s for the prevention of nonsteroidal anti-inflammatory drug (NSAID)-induced peptic ulcers. It is now used much more widely for 'off-label' indications like medication abortion, medical management of miscarriage, cervical ripening before surgical procedures, treatment of postpartum hemorrhage, and induction of labour. The lack of a specific license for Cytotec® to be used in obstetrics and gynecology has led to a number of problems regarding correct dose and dose regime. The study is an open-label, randomized, single-dose, comparative, parallel design, bioavailability study followed by repeat dosing of of two formulations misoprostol in healthy adult females being induced to go into labour. The drug shall be administered orally or sublingually.
Interventions
DRUGAngusta™
One tablet of Angusta™ (25 µg) given every 2 hours
DRUGCytotec®
1/8 of a tablet of Cytotec® (25 µg) given every 2 hours. Drug administration should be repeated every 2 hours until labour has commenced.
Sponsors
Region Skane
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult females * Women wanting to participate and having given informed consent * Known to have reached week 37 + 0 days to week 42 + 2 days of gestation * With a viable fetus in a vertex position * Age above or equal to 18 years old * Women opting for vaginal delivery * BMI between 20 and 30 kg/m2
Exclusion criteria
* Women with known allergy to misoprostol or other prostaglandins * Women with prior caesarean section * Women with dead or anomalous fetus * Women with twin pregnancy * Women with known liver or renal dysfunction
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| AUC (area under the curve) 0-t misoprostol | For 2 hours regime: pre-dose, 5, 10, 20, 30, 40, 50, 75, 100 and 120 min post-dose. For 4-hours regime at pre-dose, 5, 10, 20, 30, 40, 50, 75, 100,120, 180 and 240 min post-dose |
| AUC (area under the curve) 0-inf of misoprostol | For 2 hours regime: pre-dose, 5, 10, 20, 30, 40, 50, 75, 100 and 120 min post-dose. For 4-hours regime at pre-dose, 5, 10, 20, 30, 40, 50, 75, 100,120, 180 and 240 min post-dose |
Secondary
| Measure | Time frame |
|---|---|
| APGAR score of infant | At time of birth |
| t max (Time to maximum) of misoprostol | For 2 hours regime: pre-dose, 5, 10, 20, 30, 40, 50, 75, 100 and 120 min post-dose. For 4-hours regime at pre-dose, 5, 10, 20, 30, 40, 50, 75, 100,120, 180 and 240 min post-dose |
| Adverse event / Serious Adverse event profile. | From screening and until 7 days post treatment. |
| Cardiotochographic (CTG) monitoring. | During labour |
| t 1/2 (Elimination half-life) of misoprostol | For 2 hours regime: pre-dose, 5, 10, 20, 30, 40, 50, 75, 100 and 120 min post-dose. For 4-hours regime at pre-dose, 5, 10, 20, 30, 40, 50, 75, 100,120, 180 and 240 min post-dose |
Countries
Sweden
Outcome results
None listed