Obstetrical Gel Use to Shorten Labor and Prevent Lower Genital Tract Trauma

Labor Stage, Second Clinical Trial

Official title:

Obstetrical Gel Use to Shorten Labor and Prevent Lower Genital Tract Trauma: A Randomized Controlled Trial

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03518684
• Other study ID #: OGY.EH.03
• Status: Completed
• Phase: Phase 4
• Start date: April 3, 2018
• Est. completion date: June 30, 2019

Study information

• Verified date: September 2020
• Source: American University of Beirut Medical Center
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Recent literature shows that birth injury is associated with postpartum pelvic floor dysfunction (pelvic organ prolapse and fecal and urinary incontinence). Prolonged labor, namely during the 2nd stage, is one of the main obstetric risk factors responsible for anal sphincter rupture and fecal incontinence. In addition, it is associated with increased maternal and neonatal morbidities including increased risk of lower genital tract lacerations. In an effort to shorten labor and decrease lower genital tract trauma many techniques have been investigated.

The objective of our study is to investigate whether the use of obstetric gel shortens the first and second stage of labor and exerts a protective effect on the lower genital tract. Neonatal and maternal morbidities will be also assessed.

The study design will be a randomized controlled trial of 2 groups, where the patients presenting for vaginal delivery will be randomly assigned to either:

• Group 1 who will receive the standard care during labor and delivery

• Group 2 who will receive the standard care during labor and delivery with the vaginal application of the obstetrical gel The goal of this randomized controlled study is to compare the length of the first and 2nd stage of labor and the lower genital tract integrity in the 2 groups of patients.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 160
• Est. completion date: June 30, 2019
• Est. primary completion date: June 28, 2019
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: Female
• Age group: 18 Years to 40 Years

Eligibility

Inclusion Criteria:

• Age between 18 and 40 years

• Intended vaginal delivery

• Singleton baby in vertex presentation

• Low risk pregnancy at term (37-42 weeks of gestation)

• Estimated birth weight between 2000 g and 4500 g (clinically or by sonography)

• Signed written informed consent

Exclusion Criteria:

• Contraindications for vaginal delivery (placenta previa, active herpes infection, etc…)

• Advanced cervical dilation (= 5 cm)

• Suspected amniotic infection (fever, foul smelling discharge, fetal tachycardia, abdominal pain)

• Non reassuring fetal heart tracing

• Prolonged rupture of the membranes (24 hours)

• Suspected major fetal malformations

• Suspected cephalopelvic disproportion

Related Conditions & MeSH terms

• Labor Stage, Second

Intervention

Drug:
• Natalis
A specially-designed sterile obstetric gel (Natalis) will be used for this trial. The obstetric gel is a birth gel with no pharmacologic effects that has a purely physical activity. It contains propylene glycol, glycerol, sodium chloride, xanthan gum, hydroxyethylcellulose and water. Starting with the first vaginal examination the obstetric gel will be used. After each vaginal examination, 3-5 mL of obstetric gel will be introduced into the vaginal birth canal in the area in front of the child using the sterile obstetric gel applicator without any manipulation or massaging. Additional obstetric gel will be added 15-30 minutes after rupture of the membranesOnce the head of the child is visible, the mouth and nose region will be wiped clean. A dry towel will be used to liberate the child in order to prevent the child from slipping

Locations

Country	Name	City	State
Lebanon	Amercian University of Beirut Medical Center	Beirut

Sponsors (1)

Lead Sponsor	Collaborator
American University of Beirut Medical Center

Country where clinical trial is conducted

Lebanon, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Reduction in the length of the second stage of labor	40% reduction in the duration of the second stage of labor with a calculated average duration of 66.5 min. Thus a reduction to 39.9 minutes for every patient recruited	Second stage of labor, a reduction to 39.9 minutes from a calculated average of 66.5 minutes