Misoprostol Dose and Timing Before Surgical Abortion at 13 to 16 Weeks' Gestation: a Randomized Trial
Overview
- Phase
- Not Applicable
- Intervention
- Misoprostol 400 mcg 3 hours prior to procedure
- Conditions
- Abortion, Induced
- Sponsor
- Planned Parenthood of Greater New York
- Enrollment
- 118
- Locations
- 1
- Primary Endpoint
- procedure time
- Status
- Completed
- Last Updated
- 5 years ago
Overview
Brief Summary
This study is a blinded randomized trial to compare two different doses and intervals of buccal misoprostol for cervical preparation before surgical abortion at 13 to 16 weeks' gestation: 400 mcg administered 3 hours before D&E (dilation and extraction), and 600 mcg administered 1.5 hours before D&E.
Primary objective: To compare operative times after two different doses and intervals of misoprostol using a non-inferiority design.
Secondary objectives: To compare the doses and intervals of misoprostol for differences in: (1) initial cervical dilation; (2) need for mechanical dilation and ease of dilation if required; (3) ability to complete the abortion procedure without further cervical preparation; (4) complications; (5) provider variables including ease of procedure and satisfaction with cervical preparation; (6) patient variables including pre-operative side effects, post-operative pain, and acceptability
Detailed Description
The investigators compared two doses and intervals of buccal misoprostol for cervical preparation before surgical abortion at 13 to 16 weeks' gestation. This blinded randomized trial compared 400 mcg misoprostol administered 3 hours and 600 mcg administered 1.5 hours before abortion. The investigators analyzed results for the primary outcome (procedure time) using a non-inferiority limit of 3 or more minutes. The investigators tested two separate non-inferiority hypotheses each powered at 95% (2.5% confidence interval) for two gestational age groups: 13.0-14.3 and 14.4-15.6 weeks. Assuming 10% withdrawals, the investigators required 118 participants. Secondary outcomes included mechanical dilation, complications, provider satisfaction, and patient side effects and acceptability.
Investigators
Eligibility Criteria
Inclusion Criteria
- •18 years of age and older
- •Eligible for pregnancy termination at Planned Parenthood of NYC
- •Able to give informed consent
- •English speaking
Exclusion Criteria
- •Reports active bleeding, severe pain, or symptoms of spontaneous labor at enrollment
- •Intrauterine fetal demise identified on pre-operative ultrasound
- •Allergy to misoprostol
Arms & Interventions
400 mcg
receives 400 mcg of misoprostol 3 hours prior to the procedure
Intervention: Misoprostol 400 mcg 3 hours prior to procedure
600 mcg
receives 600 mcg of misoprostol 90 minutes prior to the procedure
Intervention: Misoprostol 600 mcg 90 minutes prior to procedure
Outcomes
Primary Outcomes
procedure time
Time Frame: day of abortion procedure
Operative time defined as time from speculum in vagina to speculum out of vagina.