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Premature Rupture of MembranesFOLCROMNCT01973036

FOLCROM Trial: Foley Catheter in Rupture of Membranes

A study testing Foley Catheter and Oxytocin in people with Premature Rupture of Membranes, run by Geisinger Clinic at 5 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Multicenter randomized clinical trial comparing oxytocin versus oxytocin and foley catheter for induction in women who present with premature rupture of membranes who are not in labor. Read more about this study

Who is it for?
Any age, women onlyHealthy volunteers can take part
Conditions the study is for
Premature Rupture of Membranes
What is being tested?
Foley Catheter and Oxytocin
Could I receive a placebo?
No, everyone receives an active treatment
How many people
201 participants
Where
5 sitesUnited States
Study dates
Mar 2014to Aug 2016
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Any age
  • Women only
  • Healthy volunteers accepted
  • Child, Adult, Older adult

Who may be able to join

  • Spontaneous rupture of membranes (ROM) ≥1 hour prior to starting induction; ROM defined as clinical history with the presence of 2 of the following 4: pooling, ferning, nitrazine, oligohydramnios. In the absence of clinical history, oligohydramnios AND pooling must be present for ROM to be diagnosed. Oligohydramnios is defined as a total amniotic fluid index of <5cm or a maximum vertical pocket <2cm.
  • Unfavorable cervix, defined as sterile digital exam ≤ 2cm dilated / 80% effaced
  • Gestational age ≥ 34 weeks by best obstetric estimate
  • Clinical management decision is vaginal delivery
  • Singleton gestation
  • Cephalic presentation
  • Willing to participate and able to understand and sign the informed consent document before randomization
  • Women of reproductive age

Who cannot join

  • Multiple gestations
  • Lethal fetal anomalies, e.g., anencephaly, trisomy 13, trisomy 18
  • Latex allergy
  • Greater than 1 prior cesarean delivery
  • Active labor - defined as contractions more frequent than every 5 minutes (or ≥ 12 contractions in 1 hour) associated with ≥ 1 cm cervical change. In the absence of ≥ 1 cm cervical change after 2 hours, patients with contractions can be included in the study.
  • Suspicion of chorioamnionitis
Show all 12Show fewer
  • Any contraindications to vaginal delivery, including malpresentation, active herpes, complete placenta previa, greater than two prior cesarean deliveries, etc.
  • HIV positive status or AIDS
  • Intrauterine fetal demise
  • Suspected placental abruption, significant hemorrhage
  • Nonreassuring fetal heart rate (FHR) pattern
  • Participation in a competing trial

Trial locations and contacts

5 sites in 1 country.

5 sites in 1 country

United States5 sites
  • Lehigh Valley Hospital

    Allentown, Pennsylvania, 18103

  • Geisinger Medical Center

    Danville, Pennsylvania, 17822

  • Christiana Care Health System CCHS

    Newark, Delaware, 19718

  • Banner Good Samaritan Regional Medical Center

    Phoenix, Arizona, 85006

  • Geisinger Wyoming Valley

    Wilkes-Barre, Pennsylvania, 18711

Other trials in United States

About this study

Official title: Foley Catheter Versus Oxytocin for Labor Induction in Women With Term and Near Term Premature Rupture of Membranes: A Randomized Clinical Trial (FOLCROM Trial)

Multicenter randomized clinical trial comparing oxytocin versus oxytocin and foley catheter for induction in women who present with premature rupture of membranes who are not in labor.

Read the detailed description

This is a prospective, randomized, multi-center clinical trial to test the hypothesis that in women with term and near term premature rupture of membranes (PROM), an intrauterine Foley catheter plus oxytocin infusion will decrease the mean time from induction to delivery by 2.5 hours as compared to oxytocin alone.

Being tested
Foley Catheter, Oxytocin
Keywords
foley catheter, foley bulb, oxytocin
Medical subject headings
Fetal Membranes, Premature Rupture

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Foley CatheterDevice

    Also called 30cc/16 French

    The balloon will be inflated with 30 cc of sterile saline. The catheter will be taped to the patient's leg so that traction is maintained. The catheter will be assessed hourly for expulsion by a health care provider by applying gentle traction on the catheter or a vaginal examination if it is unclear by traction. Once the Foley catheter is expelled or 12 hours reached, the induction will be continued with oxytocin per this protocol.

  • OxytocinDrug

    Also called Pitocin

    Each arm will receive oxytocin at a rate of 2 milliunits/milliliter. If the fetal status is reassuring, this can be increased by 2 milliunits/milliliter every 30 minutes to achieve an adequate contraction pattern as per the institution's definition to a maximum of 30 milliunits/milliliter. This infusion may be continued until delivery.

Study groups in NCT01973036
Study groupRoleWhat they receive
OxytocinActive comparatorThis arm will receive oxytocin at a rate of 2 milliunits/milliliter. If the fetal status is reassuring, this can be increased by 2 milliunits/milliliter every 30 minutes to achieve an adequate contraction pattern as per the institution's definition to a maximum of 30 milliunits/milliliter. This infusion may be continued until delivery.
Receives: Drug: Oxytocin
Foley Catheter and OxytocinExperimentalA 30cc/16 French (16F) foley catheter will be inserted by the provider under direct visualization or by palpation, ensuring that the catheter is appropriately and adequately positioned. Oxytocin will be administered concurrently at a rate of 2 milliunits/milliliter (as noted under oxytocin active comparator). If the catheter remains in place after 12 hours, it will be deflated and removed and oxytocin infusion will continue.
Receives: Device: Foley Catheter; Drug: Oxytocin

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Time From Induction of Labor Until Delivery

    Time from induction (i.e., start time of Foley catheter or oxytocin) to delivery (hours), analyzed for all deliveries

    Measured: Time from induction to delivery (average 14.2 hours)

Secondary outcomes (17)
  1. Number of Participants With Chorioamnionitis

    Number of participants with chorioamnionitis excluding all those who were hospitalized with preterm premature rupture of membranes (PPROM) prior to 34 0/7 weeks. Chorioamnionitis was defined as temperature 38°C (or 100.4°F) or greater with at least two of the following: purulent discharge, maternal tachycardia (heart rate 100 beats per minute or greater), fetal tachycardia (heart rate 160 beats per minute or greater), foul odor of the amniotic fluid, or maternal leukocytosis (greater than 15,000 cells/mL3).

    Without Restriction = Chorioamnionitis was defined as temperature 38°C or greater and one of the following: purulent discharge, maternal tachycardia, fetal tachycardia, foul odor of the amniotic fluid, or maternal leukocytosis.

    With Restriction = Chorioamnionitis was defined as temperature 38°C or greater and two of the following: purulent discharge, maternal tachycardia, fetal tachycardia, foul odor of the amniotic fluid, or maternal leukocytosis.

    Measured: Duration of Labor (average 4.8 hours)

  2. Number of Participants With Vaginal Delivery Within 12 Hours From Placement of Foley Catheter or Start Time of Oxytocin

    Measured: Duration of Labor (average 4.8 hours)

  3. Number of Participants With Vaginal Delivery Within 24 Hours From Placement of Foley Catheter or Start Time of Oxytocin

    Measured: Duration of Labor (average 4.8 hours)

  4. Duration of First, Second and Third Stage of Labor (Minutes) for Those Undergoing Vaginal Deliveries

    Measured: Duration of Labor (average 4.8 hours)

  5. Rate of Failed Induction of Labor as the Indication for Cesarean

    This will be defined by a combination of provider documentation and cervical dilation of ≤4cm/90% effaced or ≤5cm/any effacement after a minimum of 12 hours of oxytocin in the setting of adequate contraction.

    One patient was missing information for failed induction.

    Measured: Duration of Labor (average 4.8 hours)

  6. Rate of Endomyometritis

    Endomyometritis defined as: Temperature ≥100.4°F + one of the following: fundal tenderness, maternal tachycardia (Heart Rate ≥ 100 BPM), purulent cervical discharge and no other source of fever

    Measured: Duration of hospital stay (average 3.4 days)

  7. Maternal Length of Stay, From Admission to Discharge (Days)

    Measured: Duration of hospital stay (average 3.4 days)

  8. Rate of Five Minute Apgar Score < 5

    Apgar is a test for assessing a newborn shortly after birth to determine if extra medical care or emergency care may be needed. Usually administered at 1 and 5 minutes after birth, the test includes assessment of Appearance, Pulse, Grimace, Activity and Respiration. Scores range from 0 - 10.

    Measured: Duration of hospital stay (average 3.4 days)

  9. Arterial Cord Blood Gas (pH), When Obtained

    Measured: Within 1 hour of delivery

  10. Rate of Neonatal Sepsis

    Neonatal sepsis [positive blood or cerebrospinal fluid (CSF) cultures]

    Measured: Duration of hospital stay (average 3.4 days)

  11. Neonatal Intensive Care Unit (NICU) Admission Rate

    Measured: Duration of hospital stay (average 3.4 days)

  12. Neonatal Length of Stay

    Measured: Duration of hospital stay (average 3.4 days)

  13. Number of Participants With Confirmed Histologic Chorioamnionitis/Funisitis

    Chorioamnionitis/funisitis as determined by the pathologist examining the placenta

    Measured: Duration of hospital stay (average 3.4 days)

  14. Time From Induction to Delivery (Hours)

    Time from induction to delivery (hours) excluding all those who were hospitalized with PPROM prior to 34 0/7 weeks

    Measured: Time from induction to delivery (average 14.2 hours)

  15. Overall Cesarean Delivery

    Measured: Duration of hospital stay (average 3.4 days)

  16. Rate of Chorioamnionitis

    Chorioamnionitis defined as (Temperature greater than or equal to 100.4 degrees fahrenheit or 38 degrees celsius) with at least 2 of the following: uterine tenderness, maternal tachycardia (HR greater than or equal to 100 bpm), fetal tachycardia (HR greater than or equal to 160bpm), foul odor of the amniotic fluid, or maternal leukocytosis (greater than 15000 cells/cubic milliliter)

    Measured: Duration of hospital stay (average 3.4 days)

  17. Maternal Length of Stay From Delivery to Discharge (Hours)

    Measured: Duration of hospital stay (average 3.4 days)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted31 Oct 2013 (estimated)
  2. Study startMar 2014
  3. Primary completionJul 2016
  4. Study completionAug 2016

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
201 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01973036
Sponsor's protocol ID
2013-0379
Acronym
FOLCROM
Status last verified
Jul 2018
First submitted
17 Sep 2013
Last updated
24 Sep 2018
Data monitoring committee
Yes
Individual data sharing
No

Publications

  • ACOG Practice Bulletin No. 107: Induction of labor. Obstet Gynecol. 2009 Aug;114(2 Pt 1):386-397. doi: 10.1097/AOG.0b013e3181b48ef5. No abstract available.

    PubMed 19623003
  • Gunn GC, Mishell DR Jr, Morton DG. Premature rupture of the fetal membranes. A review. Am J Obstet Gynecol. 1970 Feb 1;106(3):469-83. doi: 10.1016/0002-9378(70)90378-9. No abstract available.

    PubMed 4905833
  • LANIER LR Jr, SCARBROUGH RW Jr, FILLINGIM DW, BAKER RE Jr. INCIDENCE OF MATERNAL AND FETAL COMPLICATIONS ASSOCIATED WITH RUPTURE OF THE MEMBRANES BEFORE ONSET OF LABOR. Am J Obstet Gynecol. 1965 Oct 1;93:398-404. doi: 10.1016/0002-9378(65)90068-2. No abstract available.

    PubMed 14337377
  • Lin MG, Nuthalapaty FS, Carver AR, Case AS, Ramsey PS. Misoprostol for labor induction in women with term premature rupture of membranes: a meta-analysis. Obstet Gynecol. 2005 Sep;106(3):593-601. doi: 10.1097/01.AOG.0000172425.56840.57.

    PubMed 16135593
  • Wolff K, Swahn ML, Westgren M. Balloon catheter for induction of labor in nulliparous women with prelabor rupture of the membranes at term. A preliminary report. Gynecol Obstet Invest. 1998;46(1):1-4. doi: 10.1159/000009986.

    PubMed 9692332
  • Boulvain M, Kelly A, Lohse C, Stan C, Irion O. Mechanical methods for induction of labour. Cochrane Database Syst Rev. 2001;(4):CD001233. doi: 10.1002/14651858.CD001233.

    PubMed 11687101
  • Hannah ME, Ohlsson A, Farine D, Hewson SA, Hodnett ED, Myhr TL, Wang EE, Weston JA, Willan AR. Induction of labor compared with expectant management for prelabor rupture of the membranes at term. TERMPROM Study Group. N Engl J Med. 1996 Apr 18;334(16):1005-10. doi: 10.1056/NEJM199604183341601.

    PubMed 8598837
  • Fitzpatrick CB, Grotegut CA, Bishop TS, Canzoneri BJ, Heine RP, Swamy GK. Cervical ripening with foley balloon plus fixed versus incremental low-dose oxytocin: a randomized controlled trial. J Matern Fetal Neonatal Med. 2012 Jul;25(7):1006-10. doi: 10.3109/14767058.2011.607522. Epub 2011 Dec 14.

    PubMed 21793769
  • Pettker CM, Pocock SB, Smok DP, Lee SM, Devine PC. Transcervical Foley catheter with and without oxytocin for cervical ripening: a randomized controlled trial. Obstet Gynecol. 2008 Jun;111(6):1320-6. doi: 10.1097/AOG.0b013e31817615a0.

    PubMed 18515515
  • Oliveira MV, Oberst PV, Leite GK, Aguemi A, Kenj G, Leme VD, Sass N. [Cervical Foley catheter versus vaginal misoprostol for cervical ripening and induction of labor: a randomized clinical trial]. Rev Bras Ginecol Obstet. 2010 Jul;32(7):346-51. doi: 10.1590/s0100-72032010000700007. Portuguese.

    PubMed 21152844
  • Sanchez-Ramos L, Chen AH, Kaunitz AM, Gaudier FL, Delke I. Labor induction with intravaginal misoprostol in term premature rupture of membranes: a randomized study. Obstet Gynecol. 1997 Jun;89(6):909-12. doi: 10.1016/s0029-7844(97)00113-0.

    PubMed 9170463
  • Wing DA, Paul RH. Induction of labor with misoprostol for premature rupture of membranes beyond thirty-six weeks' gestation. Am J Obstet Gynecol. 1998 Jul;179(1):94-9. doi: 10.1016/s0002-9378(98)70256-x.

    PubMed 9704771
  • Zeteroglu S, Engin-Ustun Y, Ustun Y, Guvercinci M, Sahin G, Kamaci M. A prospective randomized study comparing misoprostol and oxytocin for premature rupture of membranes at term. J Matern Fetal Neonatal Med. 2006 May;19(5):283-7. doi: 10.1080/14767050600589807.

    PubMed 16753768
  • Tan PC, Daud SA, Omar SZ. Concurrent dinoprostone and oxytocin for labor induction in term premature rupture of membranes: a randomized controlled trial. Obstet Gynecol. 2009 May;113(5):1059-1065. doi: 10.1097/AOG.0b013e3181a1f605.

    PubMed 19384121
  • de Vaan MD, Ten Eikelder ML, Jozwiak M, Palmer KR, Davies-Tuck M, Bloemenkamp KW, Mol BWJ, Boulvain M. Mechanical methods for induction of labour. Cochrane Database Syst Rev. 2023 Mar 30;3(3):CD001233. doi: 10.1002/14651858.CD001233.pub4.

    PubMed 36996264

Questions about this trial

What is this clinical trial studying?

A study testing Foley Catheter and Oxytocin in people with Premature Rupture of Membranes, run by Geisinger Clinic at 5 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 12 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 24 Sep 2018. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 5 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 24 Sep 2018). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Time From Induction of Labor Until Delivery (time frame: Time from induction to delivery (average 14.2 hours)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01973036, which also lists 16 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Sep 2018.

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