Mifepristone Outpatient Labour Induction
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Mifepristone, Placebo.
- Who it may be relevant to
- Registry conditions: Labor, Induced. Basic parameters: from 18 years · Female.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- United Kingdom
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Overview
The number of women having an induction of labour is increasing and is currently used in 33% of pregnancies for a range of medical reasons. The majority of women are admitted to hospital to have their labour induced, using methods which are protracted and associated with a poor birth experience, making them both costly and unpopular. Further, current methods of outpatient induction are unsuitable, unsafe and/or have a poor acceptability. The COVID-19 pandemic has driven a reduction in the number of face-to-face interactions taking place across all areas of medicine. Proving the efficacy and safety of Mifepristone would significantly reduce pre-labour admission rates and hospital length of stay for pregnant women, who are at particularly higher risk of COVID-19, and reduce delivery costs.
Detailed description
The study is a double blinded, two arms, multi-centre randomised controlled clinical trial to investigate the clinical effectiveness, safety and resource utilisation of intervention for the induction of labour in women admitted to the hospital. Subjects will be randomised 1:1 to one of the two arms to receive:
Arm 1: Mifepristone + standard of care Arm 2: Placebo + standard of care
The study treatment will commence from the administration of the Mifepristone or placebo. The participants will be assessed 2 days after treatment regimen will be completed as an in-patient.
Interventions
- Drug Mifepristone
Progestin Antagonist - Drug Placebo
Placebo
Primary outcome measures
- Measure of women in labour or delivered within 2 days of intervention [Time frame: up to 2 days after administration of intervention]
Secondary outcome measures (3)
- Change in clinical outcomes [Time frame: up to 6 weeks after delivery]
- Determine whether intervention reduces resource utilisation and patient experience [Time frame: after delivery and up to 6 weeks after delivery]
- To assess the efficacy and safety of Mifepristone for the outpatient induction of labour [Time frame: up to 6 weeks after delivery]
Eligibility criteria
Inclusion criteria
- Pregnant women between 36+5 and 41+5 weeks of gestation
- Singleton pregnancy
- Aged 18 years or older
- Unfavourable cervix (Bishop Score less than or equal to 6)
- The ability to understand and sign a written informed consent form, prior to participation in any screening procedures and must be willing to comply with all study requirements.
Exclusion criteria
- Breech presentation
- Early labour
- Contraindication to vaginal birth (placenta praevia, transverse lie, known or suspected cephalo-pelvic disproportion or other factor contraindicated to vaginal birth in the opinion of the investigator)
- Fetal growth restriction with oligohydramnios and/or abnormal Dopplers
- Presence of reduced fetal movements requiring urgent delivery, abnormal CTG or recent antepartum haemorrhage requiring immediate delivery
- Medical conditions:
i. sexually transmitted infections (active infections only) ii. bleeding disorders, on anticoagulants, steroid or aspirin therapy iii. prior uterine operations (Caesarean Section or myomectomy)
- Contra-indications to mifepristone including chronic adrenal, hepatic, renal failure
- Hypersensitivity to mifepristone or to any excipients, or malnutrition
- Severe asthma uncontrolled by therapy and inherited porphyria
- Any investigational drug with an expected interaction with mifepristone which has been administered within 30 days prior to the trial drug administration.
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Quadruple blind
- Primary purpose
- Prevention
Study locations
United Kingdom · 1 center
- Chelsea and Westminster Hospital — London
Identifiers
NCT: NCT05177510 · CW003 · 2021-004860-93