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Sponsored by: |
Hillel Yaffe Medical Center |
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Information provided by: | Hillel Yaffe Medical Center |
ClinicalTrials.gov Identifier: | NCT00604487 |
Artificial ripening of the cervix and induction of labor remain as one of the therapeutic challenges in Obstetrics. The method widely used, the intravenous administration of Oxytocin, is associated with prolonged induction periods, a significant failure rate, and considerable patient discomfort. Therefore, over the years, a variety of locally applied pharmacological and physical ripening agents were evaluated. Currently, the commonly utilised local ripening agent is a Prostaglandin (PG) preparation. Although PG is being applied vaginally or extra-amniotically, systemic absorption of this agent is common, sometimes resulting in uterine hypertonicity, nausea and vomiting. In addition, both induction methods are associated with the initiation of uterine contractions, sometimes lasting for prolonged periods. Therefore a preferred induction method may be a mechanical one which will lead to cervical ripening without causing uterine contractions. Furthermore, there are additional potential advantages of mechanical methods compared to pharmacologic methods such as, ease of storage, low cost and less side effects. A folly catheter, inserted through the cervix, combined with continuous extra-amniotic NS instillation is being used for this purpose for many years. However this method although effective may cause uncomfortable traction of the balloon to the women's leg. Furthermore, dripping of saline through the cervix and vagina, occasionally occurs, may be annoying, and may be confused with rupture of membrane. We have recently introduced a newly developed balloon device (Atad Ripener Device), which was designed with one balloon located at the distal end of the device (the uterine balloon, U), while the other balloon is located 1.5 cm proximal to the first one (the cervicovaginal balloon, CV). Both balloons are expandable with Saline. The balloon inflated in the vagina provides the traction action and seals the cervix from saline leakage. Another balloon the AID (Atad double balloon Instillation Device) is identical to the ARD but has an additional long tip for instillation of normal to the extra-amniotic space. To the best of our knowledge, no comparison was performed between the use of the double balloon ripener device and folly catheter for induction of labor. Furthermore, there are no published data regarding the use of the double balloon instillation device (AID) combined with continuous extra-amniotic NS instillation. This study is designed to compare the efficacy, safety and side effects of mechanical methods of cervical ripening and labor induction by the double balloon device (ARD), the double balloon instillation device (AID) combined with continuous extra-amniotic instillation of normal saline and the folly catheter combined with continuous extra-amniotic normal saline instillation. The study aims at the accrual of 300 women (100 randomised in each arm).
Condition | Intervention |
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Unfavorable Cervix for Induction of Labor |
Device: ARD (Atad Ripener Device) Device: AID (Atad double balloon Instillation Device) Device: folly catheter |
Study Type: | Interventional |
Study Design: | Treatment, Randomized, Open Label, Parallel Assignment |
Estimated Enrollment: | 300 |
Study Start Date: | January 2008 |
Estimated Study Completion Date: | December 2011 |
Estimated Primary Completion Date: | January 2010 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
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1: Active Comparator
Insertion of the Atad double balloon ripener device (100 ml NS in each balloon).
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Device: ARD (Atad Ripener Device)
Atad double balloon ripener device
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2: Active Comparator
Insertion of the double balloon instillation device (100 ml NS in each balloon) and continuous extra-amniotic instillation of NS 50 Ml/hour
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Device: AID (Atad double balloon Instillation Device)
Double balloon instillation device and continuous extra-amniotic instillation of NS 50 Ml/hour
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3: Active Comparator
Insertion of the folly catheter (40 ml NS in the balloon) and continuous extra-amniotic instillation of NS 50 Ml/hour
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Device: folly catheter
folly catheter (40 ml NS in the balloon) and continuous extra-amniotic instillation of NS 50 Ml/hour
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Ages Eligible for Study: | 18 Years and older |
Genders Eligible for Study: | Female |
Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
Exclusion Criteria:
Israel | |
Hillel Yaffe Medical Center | Recruiting |
Hadera, Israel, 38100 | |
Contact: Osnat Walfisch, MD 972 4 6304248 | |
Contact: Elad Mei-dan, coordinator 972 4 6304248 eladmei@yahoo.com | |
Principal Investigator: Hallak Mordechai, MD | |
Sub-Investigator: Elad Mei-dan, M.D. | |
Sub-Investigator: Osnat Walfisch, M.D. |
Principal Investigator: | Mordechai Hallak, M.D. | Department of Obstetrics & Gynecology, Hillel Yaffe Medical Center, Hadera |
Responsible Party: | Hillel Yaffe Medical Center ( Hillel Yaffe Medical Center ) |
Study ID Numbers: | inductionCTIL, no grant |
Study First Received: | January 17, 2008 |
Last Updated: | February 10, 2008 |
ClinicalTrials.gov Identifier: | NCT00604487 History of Changes |
Health Authority: | Israel: The Israel National Institute for Health Policy Research and Health Services Research |
induction cervix balloon Bishop |