Protocol summary
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Study aim
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Determining the effect and effectiveness of sildenafil citrate on fetal distress and the rate of cesarean section
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Design
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Clinical trial with control group, with parallel groups, double-blind, randomized, phase 3 on 104 patients. The online system was used for randomization. https://www.sealedenvelope.com/simple-randomiser/v1/lists
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Settings and conduct
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Pregnant mothers referred to Al-Zahra Hospital in Rasht divided into two groups of control and case, they are divided into equal numbers and randomly after entering the study, a test package is given to each participant in order numbered in order. The first dose of sildenafil or placebo is given when the participant enters the labor department for delivery. Sildenafil is given orally 50 mg every 6 hours for a maximum of 3 doses. The placebo is given to the control group according to the instructions.
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Participants/Inclusion and exclusion criteria
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Subjects include pregnant women referring to Alzahra Hospital in Rasht for normal delivery. Inclusion conditions: aged between 18-40 years, with singleton pregnancy (37-41 weeks), has a normal fetal structure, with cephalic presentation without any anomalies, estimated weight above 2500 grams or without CPD, who are candidate for normal vaginal delivery included in this survey. Exclusion criteria: drug reaction to Sildenafil, fetal anomalies, metabolic disorder, cardiac disorders, visual disorders, renal disorders, liver anomalies, previous cesarean, preeclampsia, HTN, Alcohol, Taking medications Nitrate, α-blocker.
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Intervention groups
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Intervention group: A group of 104 people who receive a package containing three capsules sildenafil 50 mg with instructions for clinical staff. Control group : A group of 104 people who receive a package containing three placebo capsules.
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Main outcome variables
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Need for cesarean section
General information
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Reason for update
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To enter the actual date of start and end of sampling
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Acronym
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Sildenafil citrate
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IRCT registration information
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IRCT registration number:
IRCT20100303003485N5
Registration date:
2022-07-20, 1401/04/29
Registration timing:
prospective
Last update:
2023-02-25, 1401/12/06
Update count:
1
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Registration date
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2022-07-20, 1401/04/29
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Registrant information
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Recruitment status
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Recruitment complete
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Funding source
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Expected recruitment start date
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2022-07-23, 1401/05/01
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Expected recruitment end date
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2022-09-23, 1401/07/01
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Actual recruitment start date
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2022-07-23, 1401/05/01
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Actual recruitment end date
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2022-09-23, 1401/07/01
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Trial completion date
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2022-09-23, 1401/07/01
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Scientific title
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The effect of sildenafil citrate on fetal distress during labor and cesarean section - a double-blind clinical trial with placebo
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Public title
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The effect of sildenafil citrate on cesarean section during labor
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Purpose
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Prevention
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Inclusion/Exclusion criteria
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Inclusion criteria:
Age between 18-40 years
Single pregnancy
Term pregnancy (37-41 weeks)
Normal fetal structure and without any anomalies
Cephalic presentation
Estimated weight above 2500 grams
Without CPD
Candidate for normal vaginal delivery
Exclusion criteria:
Drug reaction to Sildenafil
Fetal anomalies
Metabolic disorder
Cardiac disorders
Renal disorders
Visual disorders
Liver anomalies
Previous cesarean
Preeclampsia
HTN
Alcohol
Taking medications Nitrate
α-blocker
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Age
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From 18 years old to 40 years old
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Gender
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Female
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Phase
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3
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Groups that have been masked
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- Participant
- Care provider
- Investigator
- Outcome assessor
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Sample size
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Target sample size:
104
Actual sample size reached:
104
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Randomization (investigator's opinion)
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Randomized
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Randomization description
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208 pregnant mothers referred to Al-Zahra Hospital in Rasht are randomly divided into 2 groups of 104 (intervention and control). Group 1 (intervention) is called A and group 2 (control) is called B. Random blocking will be done in such a way that numbers are assigned to the research units in order. Then there is a table with 47 rows called blocks and each block will have 4 parts and each part is named A and B, will be considered. In the next step, the numbers are placed in each house in order. After all the numbers are placed in the blocks, People who had a number in house A, Package with code A and people who had a number in house B, They will receive a package with code B. Concealment is done using the sealed envelope method. An online randomization service was used to generate the list.
https://www.sealedenvelope.com/simple-randomiser/v1/lists
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Blinding (investigator's opinion)
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Double blinded
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Blinding description
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The treatment group of each patient(The intervention group receiving sildenafil capsules and the control group receiving placebo capsules) will be determined only after randomization. This project will be carried out by a group of medical experts and all people will be blind (participants, Principal investigator, Health care personnel who are responsible for taking care of patients, Responsible for data collection, those who evaluate the outcome), Except for one specialist doctor who is independent from the research team, who prescribes the assigned codes for each of the pregnant mothers who refer to Al-Zahra Rasht Hospital. Also, each group of patients (intervention and control) will be treated in a separate place and are not related to each other.
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Placebo
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Used
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Assignment
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Parallel
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Other design features
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Ethics committees
1
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Ethics committee
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Approval date
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2022-06-01, 1401/03/11
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Ethics committee reference number
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IR.GUMS.REC.1401.114
Health conditions studied
1
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Description of health condition studied
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Fetal distress in pregnancy
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ICD-10 code
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ICD-10 code description
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Primary outcomes
1
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Description
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Need for cesarean section
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Timepoint
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The first dose of sildenafil or placebo when the participant is in the active phase of labor. For delivery, she enters the labor department and is given. Sildenafil is given orally 50 mg every 8 hours for a maximum of 3 doses.
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Method of measurement
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The patient's blood pressure is measured every 15-30 minutes. Fetal heart rate is monitored.
Secondary outcomes
1
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Description
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Type of delivery
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Timepoint
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Until every stage of childbirth.
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Method of measurement
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Will be recorded in the checklist.
2
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Description
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Cesarean section indication
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Timepoint
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Until every stage of childbirth.
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Method of measurement
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Will be recorded in the checklist.
3
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Description
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Labor duration
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Timepoint
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Until every stage of childbirth.
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Method of measurement
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Will be recorded in the checklist.
4
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Description
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Abnormal bleeding during and after delivery
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Timepoint
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Until after delivery
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Method of measurement
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Will be recorded in the checklist.
5
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Description
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Meconium excretion
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Timepoint
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Until every stage of childbirth.
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Method of measurement
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Will be recorded in the checklist.
6
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Description
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Need for fetal blood sampling
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Timepoint
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Until every stage of childbirth.
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Method of measurement
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Will be recorded in the checklist.
7
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Description
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Fetal distress
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Timepoint
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Until every stage of childbirth.
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Method of measurement
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Will be recorded in the checklist.
8
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Description
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Birth weight
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Timepoint
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After delivery
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Method of measurement
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Will be recorded in the checklist.
9
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Description
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Neonatal sex
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Timepoint
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After delivery
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Method of measurement
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Will be recorded in the checklist.
10
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Description
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Apgar scores
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Timepoint
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After delivery
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Method of measurement
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Will be recorded in the checklist.
11
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Description
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Umbilical artery pH
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Timepoint
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Until every stage of childbirth.
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Method of measurement
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Will be recorded in the checklist.
12
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Description
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Need for neonatal resuscitation
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Timepoint
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After delivery
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Method of measurement
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Will be recorded in the checklist.
13
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Description
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Length of time in neonatal intensive care unit
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Timepoint
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After delivery
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Method of measurement
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Will be recorded in the checklist.
14
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Description
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Seizures
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Timepoint
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After delivery
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Method of measurement
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Will be recorded in the checklist.
15
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Description
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Neonatal encephalopathy
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Timepoint
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After delivery
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Method of measurement
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Will be recorded in the checklist.
16
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Description
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Fetal and infant death
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Timepoint
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After delivery
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Method of measurement
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Will be recorded in the checklist.
Intervention groups
1
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Description
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Intervention group: a group of 104 people who received a package containing three oral capsules of sildenafil 50 mg brand Marham Darou (SDF), prepared by the pharmacy, up to a maximum of 3 doses every 6 hours. The first dose of sildenafil is given when the participant enters the labor ward for delivery (Spontaneous birth with dilatation of less than 4 cm, pregnant women who have cervical rip and induction has started for them and have effective contractions or induction of labor with oxytocin or rupture of the water sac) and the patient's blood pressure is measured every 15-30 minutes. Fetal heart rate monitoring is done and pregnancy care is ensured in both study groups.
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Category
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Prevention
2
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Description
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Control group: a group of 104 people who received a package containing three oral capsules of Mehram Daro brand prepared by the pharmacy, receive up to 3 doses every 6 hours. The first placebo dose is given when the participant enters the labor ward for delivery(Spontaneous birth with dilatation of less than 4 cm, pregnant women who have cervical rip and induction has started for them and have effective contractions or induction of labor with oxytocin or rupture of the water sac) and the patient's blood pressure is measured every 15-30 minutes. Fetal heart rate monitoring is done and pregnancy care is ensured in both study groups.
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Category
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Prevention
1
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Sponsor
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Grant name
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Grant code / Reference number
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Is the source of funding the same sponsor organization/entity?
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Yes
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Title of funding source
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Rasht University of Medical Sciences
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Proportion provided by this source
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100
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Public or private sector
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Public
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Domestic or foreign origin
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Domestic
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Category of foreign source of funding
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empty
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Country of origin
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Type of organization providing the funding
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Academic
Sharing plan
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Deidentified Individual Participant Data Set (IPD)
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Undecided - It is not yet known if there will be a plan to make this available
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Study Protocol
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Yes - There is a plan to make this available
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Statistical Analysis Plan
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Undecided - It is not yet known if there will be a plan to make this available
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Informed Consent Form
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Yes - There is a plan to make this available
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Clinical Study Report
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Undecided - It is not yet known if there will be a plan to make this available
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Analytic Code
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Undecided - It is not yet known if there will be a plan to make this available
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Data Dictionary
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Undecided - It is not yet known if there will be a plan to make this available
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Title and more details about the data/document
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There is still planning to share and publish.
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When the data will become available and for how long
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The beginning of the access period is 6 months after the publication of the study results.
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To whom data/document is available
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All interested in study.
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Under which criteria data/document could be used
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Not yet planned for it
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From where data/document is obtainable
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by Email
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What processes are involved for a request to access data/document
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Not yet planned for it.
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Comments
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