Labor Induction Clinical Trial
Effıcacy of dinoprostone vaginal insert versus double- balloon catheter among women in the induction of labor
The study will be conducted in the Department of Obstetrics and Gynecology at Kanuni Sultan
Süleyman Education and Research Hospital ,İstanbul, Turkey, with approval of the local
institutional review board. All the participants will give informed consent before beginning
of the study. Women who agree to participate will be first stratified into nulliparous and
multiparous groups. Randomisation will be carried out by using sealed opaque envelopes with
a piece of paper inside marked 'PGE2 vaginal insert' or 'Double-balloon catheter'. Envelopes
will be prepared in blocks of 20 (10 PGE2 vaginal insert and 10 double-balloon catheters)
for each stratified group. Envelopes will be then shuffled and placed in boxes marked
'nulliparous' and 'multiparous'. The investigator is not blinded to the allocation
procedure. The allocated envelope will be opened by the clinician performing the initial
vaginal examination just prior to that examination.
In the group assigned to mechanical ripening , a double- balloon catheter (Cook Cervical
Ripener Balloon,Cook OB/GYN,Spencer IN) is inserted into cervical canal under direct
visualisation during a sterile speculum examination. Once both balloon enter the cervical
canal, the first balloon is filled with 40 ml saline above the level of the internal os. The
second (vaginal) balloon is the inflated with 20 ml of saline.Then both of them are filled
with 60 ml of saline. The external end of the device is taped without traction to the medial
aspect of the woman's thigh. After completion of the device placement, patients undergo
continous fetal heart rate monitoring for 30 min then are allowed to ambulate.The double
ballon is placed for 12 hours .
In the group randomly assigned to vaginal insert is placed high in the vaginal fornix, the
patients are monitored at least 1 hour for fetal heart rate and uterine activity and they
are allowed to ambulate.
After 12 hours oxytocin isadministered using a standard dose regimen to all patients.
Primary and secondary outcomes are measured.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Treatment
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