According perinatal surveys, induction of labor is performed at more than 20% of pregnant women. According to a survey on the trigger practices in France, prostaglandins are widely used to initiate cervical ripening, usually by laying intravaginal dinoprostone (Propess®). The overall work-up rate due to the use of a single Propess® is 74.6% with 80% of vaginal deliveries. Currently, 25.4% of patients who was not put in work after 24 hours are triggered by oxytocin (Syntocinon®) or directly caesarean. The initial installation of intravaginal dinoprostone limits the use of oxytocin (Syntocinon®) or in lower doses. Using a second Propess® is carried out in several maternity hospitals, as reported by the survey on the cervical ripening practices in France. This second administration could be the solution to reduce the rate of caesarean in France which amounted to 20.8%.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
160
In case of failure of cervical ripening after a first intravaginal delivery device of Dinoprostone (Propess® 10 mg), patients receive a second Propess®, followed by Oxytocin 5U.I/ml (Syntocinon®) (if necessary) and epidural analgesia if desired by the patient.
In case of failure of cervical ripening after a first intravaginal delivery device of Dinoprostone (Propess® 10mg), patients receive directly Oxytocin 5U.I/ml (Syntocinon®) and epidural analgesia if desired by the patient.
CH de Blois
Blois, France
CH de BRIVE
Brive-la-Gaillarde, France
CH Metropole Savoie
Chambéry, France
Hôpital d'Estaing - CHU de Clermont-Ferrand
Clermont-Ferrand, France
CHU de LIMOGES
Limoges, France
Hôpital Nord - APHM
Marseille, France
CH de TULLE
Tulle, France
Rate of deliveries vaginally
The rate of births vaginally in each arm
Time frame: At delivery
Failure of induction of labor
The failure of induction of labor correspond to cervical dilation remaining \<3cm despite 6 hours of Syntocinon (or 1 syringe) and regular uterine contractions and amniotomy. The success of the trigger is defined by regular uterine contractions and cervical dilatation ≥ 3 cm.
Time frame: At delivery
Time of work
Time in minutes between the start of work defined by the onset of regular uterine contractions and cervical dilation ≥3 cm and delivery.
Time frame: delivery time
Caesarean indications
Caesarean indications
Time frame: At delivery
Proportion of instrumental delivery
The proportion of instrumental delivery
Time frame: At delivery
Proportion of complications of delivery and various care.
The proportion of complications of delivery and various care.
Time frame: Day 1
Proportion of complete uterine rupture
The proportion of complete uterine rupture
Time frame: At delivery
Transfer in Intensive Care Unit
The transfer in Intensive Care Unit
Time frame: 10 Days
Maternal death
Maternal death
Time frame: 10 Days
Hospital stay of mother
Hospital stay of mother
Time frame: 10 Days
Apgar score
Determination of Apgar score
Time frame: 3 Min, 5 Min and 10 Min
Visual estimation of presence of amniotic fluid meconium
Visual estimation of presence of meconium in amniotic fluid. Absence of meconium if transparent and presence if colored.
Time frame: At the birth
Proportion of transfer neonatal or newborn intensive care unit
The proportion of transfer neonatal or newborn intensive care unit
Time frame: At the birth
Fetal / neonatal death
Fetal / neonatal death
Time frame: At the birth
Assessment of fetal acidosis by measuring of pH, lactates and base excess
Assessment of fetal acidosis by measuring of pH, lactates and base excess
Time frame: At the birth
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