Oxytocin vs Prostaglandins for Labor Induction of Women With an Unfavorable Cervix After 24h of Cervical Ripening
Status:
Recruiting
Trial end date:
2025-11-01
Target enrollment:
Participant gender:
Summary
Twenty-two percent of deliveries in France are induced. In cases where labor is induced and
cervix is unfavorable, cervical ripening prior oxytocin administration is advised in order to
reduce the risk of cesarean delivery. Cervical ripening agents, pharmacological
(prostaglandins) or mechanical are administered during 24 hours. After 24 hours, most women
will be either delivered or in labor but 25% of women will require further induction of
labor. For 16% of women who undergo cervical ripening, whatever the cervical ripening method,
the cervix remains unchanged after 24 hours. The management of these women is not consensual
and depends on the maternity unit where women are cared for.
This study seeks to identify the most appropriate strategy for the management of women with
an unfavorable cervix after 24 hours of cervical ripening, a strategy which would be
associated with the lowest maternal and perinatal morbidity but also with the best maternal
satisfaction. Because both strategies are practiced in France, the trial would compare:
induction of labor with oxytocin and repeated cervical ripening. The aim is to show that
repeating cervical ripening is an unnecessary procedure. And more specifically that oxytocin
administration is not associated with a higher caesarean delivery rate and that it reduces
the time to delivery in comparison with cervical ripening with prostaglandins.