{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T06:07:13Z","timestamp":1783836433866,"version":"3.55.0"},"reference-count":24,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>New therapies are needed to improve the risk\u2013benefit 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>Phase 2 randomized double\u2010blind placebo\u2010controlled study (PPL17; EudraCT 2019\u2010000620\u201017), conducted in two parts. The first part compared tafoxiparin 300\u2009mg vs. placebo, while the second part assessed tafoxiparin 150 and 75\u2009mg. Study treatment was administered once daily up to 7\u2009days 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 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\u2009mg group (mean slope 0.86 vs. 0.62,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006). Spontaneous onset of labor occurred in 39.8%\u201342.4% of women treated with tafoxiparin versus 28.4% with placebo. The rate of instrumental vaginal deliveries (vacuum extractions) was lowest in the tafoxiparin 300\u2009mg group (10.0% vs. 24.1% with placebo;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.013). Few serious adverse events were reported, and there was no hypercontractility related to tafoxiparin.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Tafoxiparin was effective in cervical ripening, facilitating spontaneous onset of labor and reducing the need for instrumental delivery. Benefits were most pronounced with the 300\u2009mg dose, and a favorable safety profile was observed. These results suggest that tafoxiparin may be suitable for obstetrical use in outpatient and home\u2010based settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aogs.70232","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T05:06:06Z","timestamp":1778821566000},"page":"1566-1577","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Priming of labor with tafoxiparin in nulliparous term pregnant women with unripe cervix\u2014Proof\u2010of\u2010concept and dose\u2010finding results from a randomized controlled trial"],"prefix":"10.1111","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5182-2317","authenticated-orcid":false,"given":"Gunvor","family":"Ekman\u2010Ordeberg","sequence":"first","affiliation":[{"name":"Department of Women's and Children's Health Karolinska Insitutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Jonsson","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Uppsala University  Uppsala Sweden"},{"name":"Department of Obstetrics and Gynecology Uppsala University Hospital  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4679-550X","authenticated-orcid":false,"given":"Marie","family":"Blomberg","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Link\u00f6ping University  Link\u00f6ping Sweden"},{"name":"Department of Biomedical and Clinical Sciences Link\u00f6ping University  Link\u00f6ping Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malin","family":"Melin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Skaraborg Hospital  Sk\u00f6vde Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ylva","family":"Stjernholm\u2010Vladic","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Karolinska Insitutet and Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian B.","family":"Gidl\u00f6f","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Reproductive Medicine Karolinska University Hospital  Stockholm Sweden"},{"name":"Department of Clinical Science, Intervention and Technology \u2013 CLINTEC Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dag","family":"Wide\u2010Swensson","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Sk\u00e5ne University Hospital  Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kati","family":"Tihtonen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Tampere University Hospital and Wellbeing Services County of Pirkanmaa  Tampere Finland"},{"name":"Faculty of Medicine and Health Technology Tampere University  Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inge C.","family":"Olsen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Oslo University  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"Degling\u2010Wikingsson","sequence":"additional","affiliation":[{"name":"Dilafor AB Karolinska Science Park  Solna Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per","family":"Blom","sequence":"additional","affiliation":[{"name":"Dilafor AB Karolinska Science Park  Solna Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leena","family":"Rahkonen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Helsinki University Hospital, and University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,14]]},"reference":[{"key":"e_1_2_14_2_1","unstructured":"Births: Final Data for 2021. 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