This study is designed to evaluate the safety and effectiveness of the Materna Prep Device in reducing pelvic muscle injuries during vaginal delivery. Subjects are randomized to Materna Prep Device or Standard of Care without use of the Materna Prep Device Intervention with the Materna Prep Device is expected to be a one-time use of approximately 30-90 minutes during the 1st stage of labor. Subject participation in the study is targeted to be 3 months from the time of the use of the device during delivery with optional long-term follow-up.
Vaginal delivery is a major risk factor for pelvic floor dysfunction. Clinical aspects of pelvic floor dysfunction include pelvic organ prolapse, sexual dysfunction, and fecal and urinary incontinence. Trauma to the pelvic structures occurs as the fetal head passes through the vaginal canal, especially with acute distension at the time of crowning - the exiting of the fetal head. The Materna Prep Device is a single-use, semi-automated dilator used during the first phase of labor in order to prepare the vaginal canal for vaginal delivery. By slowly pre-stretching the vagina and surrounding pelvic tissues during labor, the device is essentially dictating the strain rate of the tissue during labor. In previous feasibility studies, the elastic recovery of the tissue has been shown to be on the order of several hours, allowing the benefits of pre-stretching the vagina and surrounding pelvic tissues to last throughout labor. The device is intended to be removed prior to the initiation of the second stage of labor, for delivery to occur unobstructed. The target patient population for this study is nulliparous women entering the first phase of labor and scheduled for vaginal delivery with an epidural.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
SINGLE
Enrollment
214
Subjects are treated with Materna Prep Device prior to vaginal delivery
University of Alabama at Birmingham
Birmingham, Alabama, United States
University of California Los Angeles
Los Angeles, California, United States
The occurrence of pelvic muscle injury, defined as complete or partial detachment of the levator ani muscle diagnosed via ultrasound imagingmuscle diagnosed via ultrasound imaging
Use transperineal ultrasound to identify levator ani muscle detachment
Time frame: 3-month Follow-up
The occurrence of pelvic muscle injury, defined as complete detachment of the levator ani muscle diagnosed via ultrasound imaging
Use transperineal ultrasound to identify levator ani muscle detachment
Time frame: 3-month Follow-up
Length of 2nd Stage Labor
Compare the length of the second stage of labor, defined as the time from the cervix being dilated to 10 cm to the complete delivery of the baby between study groups.
Time frame: Day of Delivery
Levator Hiatal Area
Compare the levator hiatal area (cm2 - measurement between pelvic muscle and pelvic bone)
Time frame: 3-month Follow-up
Perineal Lacerations
Compare the rate of perineal lacerations determined by visual insepction post-delivery between study groups
Time frame: Day of Delivery
Obstetric anal sphincter injury - OASI
Compare the rate of tearing of the muscles of the anal sphincter between study groups.
Time frame: Day of Delivery
Obstetric anal sphincter injury - OASI
Compare the rate of tearing of the muscles of the anal sphincter on ultrasound between study groups.
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El Camino Hospital
Mountain View, California, United States
Christiana Care - Center for Women's & Children's Health
Newark, Delaware, United States
Mayo Clinic
Rochester, Minnesota, United States
The Cooper Health System
Camden, New Jersey, United States
Rutgers Robert Wood Johnson University Hospital
New Brunswick, New Jersey, United States
Rutgers New Jersey Medical School
Newark, New Jersey, United States
Columbia University Irving Medical Center
New York, New York, United States
The Metro Health System
Cleveland, Ohio, United States
...and 5 more locations
Time frame: 3-month Follow-up
C-Sections
Compare the rate of C-Section due to arrest of labot in the second stage
Time frame: Day of Delivery
Infant APGAR scores
Compare infant APGAR scores between study groups.
Time frame: Day of Delivery
Qualitative pelvic health feedback
Compare qualitative pelvic health feedback assessed by PFIQ-7and PFDI-20 Questionnaires
Time frame: 3-month Follow-up
Operative Delivery
Compare the rate of instrument use in vaginal deliveries between study groups
Time frame: Day of Delivery
First Push to Delivery
Compare the mean time form first push to delivery between study groups.
Time frame: Day of Delivery