NCT02393144

Brief Summary

Primary aim of this study is to analyse contemporary labor patterns by measuring rate of dilatation and head descent via transperineal ultrasonography. Labor curves will be generated using data regarding rate of dilatation, head-descent obtained via transperineal ultrasonography. Factors which are known to effect duration of labor will be taken into account.

Trial Health

43
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
1,000

participants targeted

Target at P75+ for not_applicable pregnancy

Timeline
Completed

Started Feb 2015

Geographic Reach
1 country

1 active site

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

Study Start

First participant enrolled

February 1, 2015

Completed
21 days until next milestone

First Submitted

Initial submission to the registry

February 22, 2015

Completed
25 days until next milestone

First Posted

Study publicly available on registry

March 19, 2015

Completed
1.8 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

January 1, 2017

Completed
2 months until next milestone

Study Completion

Last participant's last visit for all outcomes

March 1, 2017

Completed
Last Updated

March 19, 2015

Status Verified

March 1, 2015

Enrollment Period

1.9 years

First QC Date

February 22, 2015

Last Update Submit

March 14, 2015

Conditions

Keywords

Labor analysisTransperineal ultrasound imagingLabor curve

Outcome Measures

Primary Outcomes (3)

  • Duration of active labor

    Duration of active labor will be calculated in minutes, in a reverse fashion, beginning from time of birth and going back to first time of measurement.

    From time of initial admission until the time of birth, up to 36 hours

  • Rate of cervical dilatation advancement as measured by transperineal ultrasonography

    Rate of cervical dilatation assessment will be measured in millimetres/hour in a reverse fashion beginning from the time when maximum dilatation is achieved and going back to time of first measurement.

    From time of initial admission until the time of birth, up to 36 hours

  • Rate of angle of progression advancement as measured by transperineal ultrasonography

    Rate of angle of progression advancement will be measured in metric degree in a reverse fashion beginning from the last measurement taken and going back to first measurement taken.

    From time of initial admission until the time of birth, up to 36 hours

Secondary Outcomes (1)

  • Effect of amniotomy on duration of active labor

    From time of initial admission until the time of birth, up to 36 hours

Study Arms (2)

Spontaneous labor arm

OTHER

Women with term pregnancies whose labor started spontaneously. Spontaneous labor is determined by either spontaneous rupture of membranes at term and/or powerful, regular uterine contractions that cause cervical change. Women will be admitted to labor ward after initial assessment via transperineal ultrasonography. Labor augmentation will be performed for women with inadequate uterine contractions, i.e. contractions measuring less than Montevideo units, irregular weak uterine contractions. Analgesia will be provided via administration of 50 mg intramuscular meperidine at 2 hour intervals as required. Amniotomy will be performed for women with adequate cervical dilatation and fetal head-descent. Transperineal ultrasonography will be performed at irregular intervals to assess cervical dilatation, angle of progression and fetal head position. After birth, birth time, birth weight, APGAR scores, degree of perineal trauma, episiotomy use will be recorded.

Device: Transperineal ultrasonography, General Electric Healthcare Voluson Ultrasound SystemDevice: Cardiotocography, Bionet FC1400 Fetal MonitorOther: AmniotomyDrug: Analgesics, Opioid, MeperidineDrug: Labor augmentation, Oxytocin

Induced labor arm

OTHER

Women with term pregnancies who are induced for birth before the onset of spontaneous labor. Labor will be induced with either oxytocin infusion for women with high Bishop score, or labor will be induced with dinoprostone pessary for women requiring cervical ripening, i.e. poor. Women will be admitted to labor ward after initial assessment via transperineal ultrasonography. Analgesia will be provided via administration of 50 mg intramuscular meperidine at 2 hour intervals as required. Amniotomy will be performed for women with adequate cervical dilatation and fetal head-descent. Transperineal ultrasonography will be performed at irregular intervals to assess cervical dilatation, angle of progression and fetal head position. After birth, birth time, birth weight, APGAR scores, degree of perineal trauma, episiotomy use will be recorded.

Device: Transperineal ultrasonography, General Electric Healthcare Voluson Ultrasound SystemDevice: Cardiotocography, Bionet FC1400 Fetal MonitorOther: AmniotomyDrug: Analgesics, Opioid, MeperidineDrug: Labor induction, OxytocinDrug: Cervical ripening, labor induction, Dinoprostone

Interventions

Assessment of cervical dilatation, angle of progression and head position via transperineal ultrasonography

Induced labor armSpontaneous labor arm

Assessment of strength of uterine contractions (Montevideo units) and fetal heart rate (beat per minute) with electronic monitors.

Induced labor armSpontaneous labor arm

Artificial rupture of membranes to assess meconium staining and induce labor speed.

Induced labor armSpontaneous labor arm

Administration of meperidine for labor analgesia.

Induced labor armSpontaneous labor arm

Oxytocin infusion for augmentation of labor.

Spontaneous labor arm

Oxytocin infusion for induction of labor.

Induced labor arm

Administration of dinoprostone pessary for cervical ripening and labor induction.

Induced labor arm

Eligibility Criteria

Age16 Years - 49 Years
Sexfemale
Healthy VolunteersYes
Age GroupsChild (0-17), Adult (18-64)

You may qualify if:

  • Term pregnancies
  • Spontaneous labor
  • Induced labor

You may not qualify if:

  • Preterm pregnancy
  • Previous cesarean section
  • Fetal presentation anomalies (breech etc.)
  • th minute APGAR score lower than 7
  • Instrumental delivery (forceps or vacuum use)
  • Labor management that is not in accordance with "Safe Prevention of the Primary Cesarean Delivery" guideline by American College of Obstetrics and Gynecology.
  • Fetus suffering visible birth trauma (laceration, fracture etc.)

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Ankara University Faculty of Medicine, Department of Obstetrics and Gynecology

Ankara, 06100, Turkey (Türkiye)

RECRUITING

MeSH Terms

Interventions

CardiotocographyAmniotomyAnalgesicsAnalgesics, OpioidMeperidineOxytocinLabor, InducedCervical RipeningDinoprostone

Intervention Hierarchy (Ancestors)

Heart Function TestsDiagnostic Techniques, CardiovascularDiagnostic Techniques and ProceduresDiagnosisFetal MonitoringDiagnostic Techniques, Obstetrical and GynecologicalMonitoring, PhysiologicDelivery, ObstetricObstetric Surgical ProceduresSurgical Procedures, OperativeSensory System AgentsPeripheral Nervous System AgentsPhysiological Effects of DrugsPharmacologic ActionsChemical Actions and UsesCentral Nervous System AgentsTherapeutic UsesNarcoticsCentral Nervous System DepressantsIsonipecotic AcidsAcids, HeterocyclicHeterocyclic CompoundsPiperidinesHeterocyclic Compounds, 1-RingPituitary Hormones, PosteriorPituitary HormonesPeptide HormonesHormonesHormones, Hormone Substitutes, and Hormone AntagonistsPeptidesAmino Acids, Peptides, and ProteinsLabor, ObstetricPregnancyReproductionReproductive Physiological PhenomenaReproductive and Urinary Physiological PhenomenaProstaglandins EProstaglandinsEicosanoidsFatty Acids, UnsaturatedFatty AcidsLipidsAutacoidsInflammation MediatorsBiological Factors

Study Officials

  • Acar F Koc, Professor

    Department of Obstetrics and Gynecology, Ankara University Faculty of Medicine

    STUDY DIRECTOR

Central Study Contacts

Erkan Kalafat, M.D

CONTACT

Tuncay Yuce, M.D

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
NON RANDOMIZED
Masking
NONE
Intervention Model
SINGLE GROUP
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Research Assistant

Study Record Dates

First Submitted

February 22, 2015

First Posted

March 19, 2015

Study Start

February 1, 2015

Primary Completion

January 1, 2017

Study Completion

March 1, 2017

Last Updated

March 19, 2015

Record last verified: 2015-03

Locations