[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"trial:NCT07588529":3,"trial-entities:NCT07588529":154,"trial-summary:NCT07588529":157},{"id":4,"nct_id":4,"org_study_id":5,"brief_title":6,"official_title":7,"overall_status":8,"completion_date":9,"status_verified_date":10,"last_update_date":11,"start_date":12,"sponsor_name":13,"lead_sponsor_class":14,"has_dmc":15,"brief_summary":16,"detailed_description":17,"conditions":18,"keywords":21,"study_type":27,"primary_purpose":28,"phases":29,"enrollment_info":31,"interventions":34,"primary_outcomes":44,"secondary_outcomes":49,"sex":76,"minimum_age":77,"maximum_age":78,"healthy_volunteers":79,"eligibility_criteria":80,"std_ages":107,"locations":109,"central_contacts":128,"overall_officials":135,"references":142,"see_also_links":153},"NCT07588529","STUDY00161207","Is Nipple Stimulation Effective for Inducing Labor and Acceptable to Patients, Nurses, and Providers?","Nipple Stimulation Acceptability for Induction of Labor","NOT_YET_RECRUITING","2028-12","2026-05","2026-05-14","2026-07","University of Kansas Medical Center","OTHER",true,"In this study the investigators will be testing the use of the Symphony PLUS® breast pump for nipple stimulation. Typically, breast pumps are used to start breast milk production and collect breast milk in patients after delivering their baby. The device uses cup-shaped pieces called flanges that are placed over the patient's nipples and then a gentle vacuum or suction is applied. The mechanical effect of the suction on the nipple is thought to cause the release of a substance called oxytocin in one's body, which encourages labor and contractions to begin. Some reasons why nipple stimulation might be better than other induction of labor methods are that it allows the patient to have more control over their induction process, it uses the patient's own oxytocin instead of synthetic (or factory-produced) oxytocin, and it may shorten the time that it takes to deliver the baby.","Patients will be randomly assigned (like rolling the dice) to one of 2 groups.\n\n* Group 1 will follow the standard induction of labor protocol at KUMC. In other words, their induction process will not look any different than if they were not a participant in this study. Their induction process may include, but is not limited to, medications and\u002For devices to make the body more ready to deliver the baby, medications to increase the uterus muscle contractions, medications to decrease the pain associated with labor, etc. Group 1 will not use nipple stimulation at all as part of their labor.\n* Group 2 will follow the standard induction of labor protocol with the addition of nipple stimulation using the Symphony PLUS® breast pump for a 2-hour time period. At the time in their labor when the medical team would normally deem them appropriate to initiate synthetic oxytocin (Pitocin), nipple stimulation will be started instead. The breast pump will be placed over one nipple at a time and put on its default vacuum settings. Every 15 minutes, the patient will switch to stimulating the alternate nipple with no breaks of time in between. Depending on how fast the contractions are, the research team may increase or decrease the strength of the breast pump. This will continue for 2 hours, after which they will stop doing nipple stimulation. They will then resume normal induction of labor care as deemed appropriate by the nurses and doctors.\n\nPatients will have a 1 in 2 chance (50%) of being randomized to either Group 1 or Group 2. Group assignments will be chosen by a randomization tool. Patients and the study team will be aware of which treatment they are under.\n\nAfter delivering the baby, both groups will take a survey about their induction experience while they are in the hospital. After the survey is collected, patients have completed participation in this study. Patients will continue to receive standard care with their primary physician team.\n\nThe investigators will take information about the patients and their medical care from the electronic medical record for research purposes. The investigators will be analyzing things such as how long it took from the beginning of induction to the delivery of the baby, if there were any unexpected events, how much synthetic oxytocin was used, and other information about the induction and the health of the baby. The investigators will also analyze the results of the surveys completed.",[19,20],"Pregnancy","Induction of Labor",[22,23,24,25,26],"nipple stimulation","breast stimulation","induction","labor","induction of labor","INTERVENTIONAL","TREATMENT",[30],"NA",{"count":32,"type":33},48,"ESTIMATED",[35,40],{"type":14,"name":36,"description":37,"armGroupLabels":38},"Electric breast pump for nipple stimulation","Symphony PLUS® breast pump. What distinguishes this induction of labor nipple stimulation study is how we will be applying the nipple stimulation. Many other studies exist, but they apply the stimulation in an uneven or inconsistent manner. They often do not specify how they interpret active and latent labor. Our study will be using nipple stimulation only for 2 hours per experimental participant so that we can better quantify the effect that nipple stimulation has on the labor process.",[39],"Nipple Stimulation",{"type":14,"name":26,"description":41,"armGroupLabels":42},"Patients randomized to the control group will follow standard induction of labor protocol, which may include, but is not limited to, misoprostol, Foley catheter, and synthetic oxytocin (Pitocin).",[43],"Control",[45],{"measure":46,"description":47,"timeFrame":48},"Total Duration of Labor","The investigators will measure the time between induction of labor initiation and delivery of the baby.","From beginning of induction of labor to delivery of the baby (for each patient).",[50,53,56,60,64,68,72],{"measure":51,"description":52,"timeFrame":48},"Average amount of Pitocin used","Average Pitocin per patient used in the different study arms (nulliparous control, nulliparous experimental, multiparous control, multiparous experimental).",{"measure":54,"description":55,"timeFrame":48},"Average maximum concentration of Pitocin","The investigators will measure the average maximum concentration of Pitocin needed for each study arm (nulliparous control, nulliparous experimental, multiparous control, multiparous experimental).",{"measure":57,"description":58,"timeFrame":59},"Delivery method","Delivery method (C-section, spontaneous vaginal, or operative vaginal) by percentage needed for each study arm (nulliparous control, nulliparous experimental, multiparous control, multiparous experimental).","Time taken for delivery of newborn",{"measure":61,"description":62,"timeFrame":63},"Maternal adverse events","Adverse events (uterine tachysystole, postpartum hemorrhage, any other adverse event) by percentage that occur in each study arm (nulliparous control, nulliparous experimental, multiparous control, multiparous experimental).","From beginning of induction of labor to patient being discharged in postpartum period.",{"measure":65,"description":66,"timeFrame":67},"NICU admission","Percentage of newborns requiring NICU admission per study arm (nulliparous control, nulliparous experimental, multiparous control, multiparous experimental).","From delivery of newborn to discharge from hospital.",{"measure":69,"description":70,"timeFrame":71},"APGAR score","Average APGAR score of newborns in each study arm (nulliparous control, nulliparous experimental, multiparous control, multiparous experimental).","In the minutes directly after delivery",{"measure":73,"description":74,"timeFrame":75},"Acceptability of nipple stimulation as an induction of labor method","Surveys will be administered to patients in their postpartum period, labor and delivery nurses after the patient portion of the study has been completed, and OBGYN providers Pre and Post patient portion of the study. These surveys will ask about familiarity with nipple stimulation, how they liked using it, and if they would use it again for induction of labor.","From before patient participation to after all patients (48 total) have participated.","FEMALE","18 Years","50 Years",false,{"inclusion":81,"exclusion":87,"raw_text":106},[82,83,84,85,86],"≥18 years old and ≤ 50 years old","≥37wga and ≤ 42wga","Intact amniotic membranes","English speaking Fetal","Cephalic presentation",[88,89,90,91,92,93,94,95,96,97,98,99,100,101,102,103,104,105],"Inability to give informed consent","History of cesarean delivery or uterine myomectomy","History of uterine rupture","Intrahepatic cholestasis of pregnancy","Maternal life-threatening conditions","Active HSV","Gestational hypertension, Preeclampsia (severe or w\u002Fo severe features), HELLP, chronic hypertension on medications","Placenta previa, vasa previa","Suspicion for abnormally adherent placenta","Chorioamnionitis","Placental abruption","Multifetal gestation","category 2 or 3 fetal heart tracing upon presentation (does not include isolated variable deceleration)","EFW \\> 5000 grams in mother with diabetes","EFW \\> 4500 grams in mother without diabetes","Fetal demise","Fetal growth restriction \\\u003C10th centile","Any other contraindication for vaginal birth or anticipation of need for NICU for care of baby","Inclusion Criteria:\n\nAll patients presenting to KUMC labor \\& delivery for IOL will be considered for this study.\n\nMaternal\n\n* ≥18 years old and ≤ 50 years old\n* ≥37wga and ≤ 42wga\n* Intact amniotic membranes\n* English speaking Fetal\n* Cephalic presentation\n\nExclusion Criteria:\n\nMaternal\n\n* Inability to give informed consent\n* History of cesarean delivery or uterine myomectomy\n* History of uterine rupture\n* Intrahepatic cholestasis of pregnancy\n* Maternal life-threatening conditions\n* Active HSV\n* Gestational hypertension, Preeclampsia (severe or w\u002Fo severe features), HELLP, chronic hypertension on medications\n\nPlacental\n\n* Placenta previa, vasa previa\n* Suspicion for abnormally adherent placenta\n* Chorioamnionitis\n* Placental abruption\n\nFetal\n\n* Multifetal gestation\n* category 2 or 3 fetal heart tracing upon presentation (does not include isolated variable deceleration)\n* EFW \\> 5000 grams in mother with diabetes\n* EFW \\> 4500 grams in mother without diabetes\n* Fetal demise\n* Fetal growth restriction \\\u003C10th centile\n* Any other contraindication for vaginal birth or anticipation of need for NICU for care of baby",[108],"ADULT",[110],{"facility":13,"city":111,"state":112,"zip":113,"country":114,"contacts":115,"geoPoint":125},"Kansas City","Kansas","66103","United States",[116,121],{"name":117,"role":118,"phone":119,"email":120},"Rachel Diteresi, MD","CONTACT","913-588-6200","rditeresi@kumc.edu",{"name":122,"role":118,"phone":123,"email":124},"Brian Brost, MD","913-588-6259","bbrost@kumc.edu",{"lat":126,"lon":127},39.11417,-94.62746,[129,133],{"name":130,"role":118,"phone":131,"email":132},"Bethany Snyder","9135233650","bsnyder3@kumc.edu",{"name":134,"role":118,"phone":119,"email":120},"Rachel DiTeresi, MD",[136,139],{"name":122,"affiliation":137,"role":138},"Vice Chair of Education and Innovation in the Department of Obstetrics and Gynecology at the University of Kansas School of Medicine","STUDY_CHAIR",{"name":134,"affiliation":140,"role":141},"Clerkship Director for Obstetrics and Gynecology Department at KUMC","PRINCIPAL_INVESTIGATOR",[143,147,150],{"pmid":144,"type":145,"citation":146},"3959016","BACKGROUND","Chayen B, Tejani N, Verma U. Induction of labor with an electric breast pump. J Reprod Med. 1986 Feb;31(2):116-8.",{"pmid":148,"type":145,"citation":149},"35042047","Stark EL, Athens ZG, Son M. Intrapartum nipple stimulation therapy for labor induction: a randomized controlled external pilot study of acceptability and feasibility. Am J Obstet Gynecol MFM. 2022 Mar;4(2):100575. doi: 10.1016\u002Fj.ajogmf.2022.100575. Epub 2022 Jan 15.",{"pmid":151,"type":145,"citation":152},"7839936","Adewole IF, Franklin O, Matiluko AA. Cervical ripening and induction of labour by breast stimulation. Afr J Med Med Sci. 1993 Dec;22(4):81-5.",[],{"nct_id":4,"conditions":155,"biomarkers":156},[20,19],[],{"nct_id":4,"found":15,"summary":158,"prompt_version":168},{"design":159,"status":160,"heading":161,"summary":162,"follow_up":163,"word_count":164,"commitments":165,"compensation":166,"drugs_mentioned":167},"This is an interventional study where participants will be randomly assigned to one of two groups, like rolling dice. One group will receive standard labor induction, and the other will receive standard induction plus nipple stimulation using a breast pump.","completed","Nipple Stimulation for Inducing Labor Study","This study is looking at whether using an electric breast pump for nipple stimulation can help start labor. Researchers are comparing this method to standard ways of inducing labor, which might include medications like misoprostol or synthetic oxytocin (Pitocin). The idea is that the gentle suction from the breast pump on the nipple might release a natural substance called oxytocin in your body, which can cause contractions. You could join if you are a woman between 18 and 50 years old, at least 37 weeks pregnant but not more than 42 weeks, and your baby is head-down. The study will measure the total time it takes from when labor induction starts until the baby is delivered to see if nipple stimulation is effective. The current status of this study is unclear, and it plans to enroll 48 participants.","The primary outcome, total duration of labor, is measured from the beginning of induction until delivery of the baby.",138,"If you are in the nipple stimulation group, you will use a breast pump for two hours at a specific point in your labor. Otherwise, your induction process will be similar to standard care.","Not stated in the trial record.",[36],"v2"]