Evidence map›Paper›PMID 42135974›Full record

Trial reportActa obstetricia et gynecologica Scandinavica2026

Priming of labor with tafoxiparin in nulliparous term pregnant women with unripe cervix-Proof-of-concept and dose-finding results from a randomized controlled trial.

Gunvor Ekman-Ordeberg, Maria Jonsson, Marie Blomberg, Malin Melin, Ylva Stjernholm-Vladic, Sebastian B Gidlöf, Dag Wide-Swensson, Kati Tihtonen, Inge C Olsen, Lena Degling-Wikingsson and 2 more

Abstract readRandomized Controlled TrialClinical Trial, Phase II
In one paragraph

Trial report in Acta obstetricia et gynecologica Scandinavica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Gunvor Ekman-OrdebergDepartment of Women's and Children's Health, Karolinska Insitutet, Stockholm, Sweden.ORCID https://orcid.org/0000-0002-5182-2317
Maria JonssonDepartment of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Marie BlombergDepartment of Obstetrics and Gynecology, Linköping University, Linköping, Sweden.ORCID https://orcid.org/0000-0003-4679-550X
Malin MelinDepartment of Obstetrics and Gynecology, Skaraborg Hospital, Skövde, Sweden.
Ylva Stjernholm-VladicDepartment of Women's and Children's Health, Karolinska Insitutet and Karolinska University Hospital, Stockholm, Sweden.
Sebastian B GidlöfDepartment of Gynecology and Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden.
Dag Wide-SwenssonDepartment of Obstetrics and Gynecology, Skåne University Hospital, Lund, Sweden.
Kati TihtonenDepartment of Obstetrics and Gynecology, Tampere University Hospital and Wellbeing Services County of Pirkanmaa, Tampere, Finland.
Inge C OlsenFaculty of Medicine, Oslo University, Oslo, Norway.
Lena Degling-WikingssonDilafor AB, Karolinska Science Park, Solna, Sweden.
Per BlomDilafor AB, Karolinska Science Park, Solna, Sweden.
Leena RahkonenDepartment of Obstetrics and Gynecology, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland.

Funding

Dilafor AB, Solna, Sweden
6 · The paper itself

Abstract

introductionNew therapies are needed to improve the risk-benefit profile of intervention for labor induction. Tafoxiparin, a depolymerized form of heparin with no anticoagulant effects, has demonstrated potential to increase cervical ripening and influence the onset and outcome of labor. We assessed the effects of tafoxiparin in women with an unripe cervix scheduled for labor induction. MATERIAL AND

methodsPhase 2 randomized double-blind placebo-controlled study (PPL17; EudraCT 2019-000620-17), conducted in two parts. The first part compared tafoxiparin 300 mg vs. placebo, while the second part assessed tafoxiparin 150 and 75 mg. Study treatment was administered once daily up to 7 days or until onset of labor or ripened cervix. Study participants were nulliparous women at term with an unripe cervix and planned labor induction. The primary endpoint was the cervical ripening rate during treatment, as measured by Bishop score.

resultsOf 348 randomized women, 347 received study treatment. The primary analysis of Bishop score showed statistically significant increases in cervical ripening with tafoxiparin. The difference from placebo was most pronounced in the 300 mg group (mean slope 0.86 vs. 0.62, p = 0.006). Spontaneous onset of labor occurred in 39.8%-42.4% of women treated with tafoxiparin versus 28.4% with placebo. The rate of instrumental vaginal deliveries (vacuum extractions) was lowest in the tafoxiparin 300 mg group (10.0% vs. 24.1% with placebo; p = 0.013). Few serious adverse events were reported, and there was no hypercontractility related to tafoxiparin.

conclusionsTafoxiparin was effective in cervical ripening, facilitating spontaneous onset of labor and reducing the need for instrumental delivery. Benefits were most pronounced with the 300 mg dose, and a favorable safety profile was observed. These results suggest that tafoxiparin may be suitable for obstetrical use in outpatient and home-based settings.

Indexed as

Cervical RipeningLabor, InducedOxytocicsAdultCervix UteriDose-Response Relationship, DrugDouble-Blind MethodFemaleHumansParityPregnancyTreatment OutcomeOxytocicscervical ripeninghome treatmentlabor primingplaceborandomized controlled trialspontaneous onset of laborTafoxiparin

Identifiers

PMID42135974
PMCPMC13356465

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.