Comparing Oxytocin and Prostaglandins for Labor Induction in Women with an Unfavorable Cervix After 24 Hours of Cervical Ripening

What this Trial Is About

This research aims to compare two strategies for managing women who have an unfavorable cervix after 24 hours of cervical ripening during labor induction. It focuses on pregnant women who have not yet gone into labor despite cervical ripening and evaluates whether induction with oxytocin is as safe and effective as repeating cervical ripening with prostaglandins. The goal is to find the best approach that lowers risks for both mother and baby while also improving maternal satisfaction. Participants are divided into two groups one group receives induction of labor with intravenous oxytocin and early amniotomy following French guidelines, with oxytocin doses not exceeding 10 UI. The other group undergoes a second cervical ripening lasting up to 24 hours using one of three prostaglandin methods, chosen based on local protocols a vaginal slow-releasing dinoprostone system, oral misoprostol tablets, or vaginal dinoprostone gel. Women who remain not in labor after this second ripening then receive induction with oxytocin. During the study, researchers will monitor delivery outcomes, including cesarean delivery rates up to 2 days after intervention, time from intervention to delivery, and maternal satisfaction one month after delivery using a childbirth experience questionnaire. They will also assess various maternal and newborn health outcomes such as infections, hemorrhage, instrumental delivery, and intensive care admissions. The study is randomized and open-label, with participation expected from labor induction until shortly after delivery for assessment purposes.

Oxytocin vs Prostaglandins for Labor Induction of Women With an Unfavorable Cervix After 24h of Cervical Ripening