Trial Compares Oxytocin and Prostaglandins for Labor Induction After 24h Cervical Ripening

Approximately 22% of deliveries in France are induced, with cervical ripening often preceding oxytocin administration for women with an unfavorable cervix to lower cesarean delivery risk. Pharmacological agents like prostaglandins or mechanical methods are typically used for 24 hours. However, 25% of women still require further labor induction, and for 16%, the cervix remains unchanged after this initial period. The optimal management strategy for these women lacks consensus, leading to varied practices across maternity units and a need for evidence-based protocols.

This completed randomized controlled trial (NCT ID: NCT03138252) enrolled 180 women with an unfavorable cervix after 24 hours of initial cervical ripening. The study compared two strategies: induction of labor with oxytocin versus repeated cervical ripening using prostaglandins. The primary objective was to determine if oxytocin administration is not associated with a higher caesarean delivery rate and if it reduces the time to delivery compared to repeating cervical ripening with prostaglandins. Secondary outcomes included maternal and perinatal morbidity, and maternal satisfaction.

This record describes the protocol for a completed randomized controlled trial, not its results. Therefore, no specific findings or numerical outcomes are available from this abstract. The study's primary objective was to demonstrate that oxytocin administration for labor induction in women with an unfavorable cervix after 24 hours of cervical ripening would not increase the caesarean delivery rate and would reduce the time to delivery compared to repeating cervical ripening with prostaglandins. The investigators hypothesized that repeating cervical ripening is an unnecessary procedure, aiming to establish oxytocin as a more efficient and equally safe option. Secondary aims included assessing maternal and perinatal morbidity, and maternal satisfaction between the two approaches.