CClinicalTrials.gg
Active, not recruitingNCT07006896LIFTUpdated Sep 3, 2026

Induction of Labor After Cesarean Using Foley Alone vs. Concurrent Foley and Oxytocin

An interventional study of Foley balloon and Oxytocin in Labor Induction and Cesarean Delivery, sponsored by University of Pennsylvania. Active, not recruiting at 1 site in United States. Open to female participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-03.

Sponsored by University of Pennsylvania · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
100
Allocation
Randomized
Ages
18 Years and older
Sex
Female
01

Study summary

A randomized trial of patients undergoing a term (≥37 weeks) induction of labor with a history of one prior Cesarean delivery, wherein the provider intends to use a Foley catheter for cervical ripening. The investigators will be comparing Foley alone with concurrent Foley and Oxytocin use at the start of the induction. With this trial, the investigators aim to test our central hypothesis that concurrent Foley and Oxytocin will decrease time to delivery without increasing risks, compared to Foley alone.

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Conditions studied

  • Labor Induction
  • Cesarean Delivery

Keywords

  • Labor
  • Induction
  • Cesarean
  • TOLAC
  • Foley
  • Oxytocin
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In context

Lead sponsor

University of Pennsylvania is the lead sponsor of 1,635 studies on the registry; 239 are open to participants now.

Of its 154 completed or terminated interventional studies of FDA-regulated products, 104 (68%) have results posted.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years and older
Sexes eligible
Female
Accepts healthy volunteers
No

Inclusion criteria

  • Eligible for induction of labor
  • Live singleton gestation ≥37 weeks
  • History of 1 cesarean delivery
  • ≥18 years of age
  • Cephalic presentation
  • Intact membranes
  • English or Spanish speaking (Able to read/understand consent and instructions)
  • Cervical dilation \<3cm and Bishop score \<8

Exclusion criteria

Exclusion Criteria:

  • >1 prior Cesarean delivery
  • Known chorioamnionitis
  • Major fetal anomaly
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Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
100 participants (estimated)

Study arms

  • Experimental
    Concurrent Foley balloon and Oxytocin

    Cervical ripening will begin with a Foley balloon and concurrent oxytocin, started within 2 hour of balloon placement

    Device: Foley balloon · Drug: Oxytocin

  • Active comparator
    Foley balloon alone

    Cervical ripening will begin with a Foley balloon alone. Oxytocin will not be started until the balloon is removed or expelled, though can be considered if the balloon remains in place for \>8 hours

    Device: Foley balloon

Interventions

  • DeviceFoley balloon

    Foley balloon for induction of labor

    Also known as: Foley catheter, Cervical ripening balloon

  • DrugOxytocin

    Pitocin for induction of labor

    Also known as: Pitocin

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What researchers measure

Primary outcomes

  1. Time to delivery

    The primary endpoint will be time from start of induction until delivery (hours)

    Time frame: At delivery

Secondary outcomes

  1. Estimated postpartum blood loss

    Estimated postpartum blood loss in mL

    Time frame: At delivery

  2. Postpartum hemorrhage

    Estimated blood loss≥ 1L

    Time frame: Within 6 weeks of delivery

  3. Number of Participants with Chorioamnionitis

    Documented chorioamnionitis

    Time frame: At delivery

  4. Mode of delivery

    Successful vaginal birth after cesarean (VBAC) or repeat cesarean delivery (rCD)

    Time frame: At delivery

  5. Number of Participants with Uterine Rupture

    Uterine rupture noted at the time of cesarean delivery

    Time frame: At delivery

  6. Maternal morbidity

    Defined as a composite endpoint consisting of at least one occurrence of the following outcomes: postpartum hemorrhage, blood transfusion, endometritis, wound/laceration breakdown or infection, venous thromboembolism and hospital readmission with 6 weeks

    Time frame: Within 6 weeks of delivery

  7. Neonatal morbidity

    Defined as neonatal resuscitation requiring supplemental oxygen outside of the delivery room for at least 12 hours of culture proven/presumed neonatal sepsis

    Time frame: Within 6 weeks of delivery

  8. Maternal length of stay

    Measured by hours from admission to postpartum discharge

    Time frame: From date of delivery to date of discharge from hospital postpartum, up to 6 weeks from delivery

  9. Neonatal length of stay

    Length of stay from birth to discharge, measured in hours

    Time frame: From date of delivery to date of discharge from hospital postpartum, up to 6 weeks from delivery

  10. NICU stay greater than 48 hours

    Admission to the NICU for more than 48 hours

    Time frame: From date of delivery to date of discharge from hospital postpartum, up to 6 weeks from delivery

  11. Maternal patient satisfaction as measured by the Hollins Martin Birth Satisfaction scale-Revised (BSS-R)

    Patient satisfaction as measured by the BSS-R with a possible score of 0-40 with 0 equaling the least birth satisfaction

    Time frame: From time of delivery to discharge from hospital, up to 6 weeks from delivery

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Study locations

1 site
  • Hospital of the University of Pennsylvania
    Philadelphia, Pennsylvania 19146, United States
08

References and documents

Publications

  • Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009 Apr;42(2):377-81. doi: 10.1016/j.jbi.2008.08.010. Epub 2008 Sep 30. PubMed 18929686 ↗
  • Hollis S, Campbell F. What is meant by intention to treat analysis? Survey of published randomised controlled trials. BMJ. 1999 Sep 11;319(7211):670-4. doi: 10.1136/bmj.319.7211.670. PubMed 10480822 ↗
  • Schulz KF, Altman DG, Moher D; CONSORT Group. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ. 2010 Mar 23;340:c332. doi: 10.1136/bmj.c332. PubMed 20332509 ↗
  • Levine LD, Downes KL, Hamm RF, Srinivas SK. Evaluating the impact of a standardized induction protocol to reduce adverse perinatal outcomes: a prospective cohort study. J Matern Fetal Neonatal Med. 2021 Oct;34(19):3200-3207. doi: 10.1080/14767058.2019.1680629. Epub 2019 Oct 24. PubMed 31645154 ↗
  • Committee on Practice Bulletins-Obstetrics. Practice Bulletin No. 183: Postpartum Hemorrhage. Obstet Gynecol. 2017 Oct;130(4):e168-e186. doi: 10.1097/AOG.0000000000002351. PubMed 28937571 ↗
  • Jamaluddin A, Azhary JMK, Hong JGS, Hamdan M, Tan PC. Early versus delayed amniotomy with immediate oxytocin after Foley catheter cervical ripening in multiparous women with labor induction: A randomized controlled trial. Int J Gynaecol Obstet. 2023 Feb;160(2):661-669. doi: 10.1002/ijgo.14361. Epub 2022 Aug 8. PubMed 35869943 ↗
  • Gomez Slagle HB, Fonge YN, Caplan R, Pfeuti CK, Sciscione AC, Hoffman MK. Early vs expectant artificial rupture of membranes following Foley catheter ripening: a randomized controlled trial. Am J Obstet Gynecol. 2022 May;226(5):724.e1-724.e9. doi: 10.1016/j.ajog.2021.11.1368. Epub 2022 Feb 6. PubMed 35135684 ↗
  • Secchi D, Alberic J, Gobillot S, Ghenassia A, Roustit M, Chauleur C, Hoffmann P, Raia-Barjat T. Balloon catheter vs oxytocin alone for induction of labor in women with one previous cesarean section and an unfavorable cervix: a multicenter, retrospective study. Arch Gynecol Obstet. 2022 Aug;306(2):379-387. doi: 10.1007/s00404-021-06298-y. Epub 2021 Oct 28. PubMed 34708257 ↗
  • Hoffman MK, Hunter Grant G. Induction of labor in women with a prior cesarean delivery. Semin Perinatol. 2015 Oct;39(6):471-4. doi: 10.1053/j.semperi.2015.07.011. Epub 2015 Sep 11. PubMed 26365010 ↗
  • West HM, Jozwiak M, Dodd JM. Methods of term labour induction for women with a previous caesarean section. Cochrane Database Syst Rev. 2017 Jun 9;6(6):CD009792. doi: 10.1002/14651858.CD009792.pub3. PubMed 28599068 ↗
  • Kehl S, Weiss C, Rath W. Balloon catheters for induction of labor at term after previous cesarean section: a systematic review. Eur J Obstet Gynecol Reprod Biol. 2016 Sep;204:44-50. doi: 10.1016/j.ejogrb.2016.07.505. Epub 2016 Aug 3. PubMed 27521597 ↗
  • Levin G, Tsur A, Burke YZ, Meyer R. Methods of induction of labor after cesarean with no prior vaginal delivery-Perinatal outcomes. Int J Gynaecol Obstet. 2023 Feb;160(2):612-619. doi: 10.1002/ijgo.14318. Epub 2022 Jul 14. PubMed 35751576 ↗
  • Landon MB, Hauth JC, Leveno KJ, Spong CY, Leindecker S, Varner MW, Moawad AH, Caritis SN, Harper M, Wapner RJ, Sorokin Y, Miodovnik M, Carpenter M, Peaceman AM, O'Sullivan MJ, Sibai B, Langer O, Thorp JM, Ramin SM, Mercer BM, Gabbe SG; National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Maternal and perinatal outcomes associated with a trial of labor after prior cesarean delivery. N Engl J Med. 2004 Dec 16;351(25):2581-9. doi: 10.1056/NEJMoa040405. Epub 2004 Dec 14. PubMed 15598960 ↗
  • Deshmukh U, Denoble AE, Son M. Trial of labor after cesarean, vaginal birth after cesarean, and the risk of uterine rupture: an expert review. Am J Obstet Gynecol. 2024 Mar;230(3S):S783-S803. doi: 10.1016/j.ajog.2022.10.030. Epub 2023 Jul 13. PubMed 38462257 ↗
  • 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 ↗
  • Bruno AM, Allshouse AA, Metz TD. Trends in Attempted and Successful Trial of Labor After Cesarean Delivery in the United States From 2010 to 2020. Obstet Gynecol. 2023 Jan 1;141(1):173-175. doi: 10.1097/AOG.0000000000004998. Epub 2022 Nov 30. PubMed 36701618 ↗
  • ACOG Practice Bulletin No. 205: Vaginal Birth After Cesarean Delivery. Obstet Gynecol. 2019 Feb;133(2):e110-e127. doi: 10.1097/AOG.0000000000003078. PubMed 30681543 ↗
  • Stephenson J. Rate of First-time Cesarean Deliveries on the Rise in the US. JAMA Health Forum. 2022 Jul 1;3(7):e222824. doi: 10.1001/jamahealthforum.2022.2824. No abstract available. PubMed 36219002 ↗

Individual participant data

Plan to share: No

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 3, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT07006896
Lead sponsor
University of Pennsylvania
Responsible party
Lisa Levine (Associate Professor, University of Pennsylvania) — Principal investigator
First posted
Jun 5, 2025
Start date
Jul 10, 2025
Primary completion
Jul 25, 2026
Completion
May 1, 2027 (estimated)
Last update
Sep 3, 2026

Study contacts

Lisa Levine, MD MSCE
principal investigator · University of Pennsylvania

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is active, not recruiting, as verified in Sep 2026. You cannot join it, but the record below documents what was studied.

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