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Misoprostol Dose and Timing Before Surgical Abortion at 13 to 16 Weeks' Gestation: a Randomized Trial

Registration Number
NCT02279914
Lead Sponsor
Planned Parenthood of Greater New York
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.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
118
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

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
400 mcgMisoprostol 400 mcg 3 hours prior to procedurereceives 400 mcg of misoprostol 3 hours prior to the procedure
600 mcgMisoprostol 600 mcg 90 minutes prior to procedurereceives 600 mcg of misoprostol 90 minutes prior to the procedure
Primary Outcome Measures
NameTimeMethod
procedure timeday of abortion procedure

Operative time defined as time from speculum in vagina to speculum out of vagina.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Planned Parenthood of New York City - Margaret Sanger Center

🇺🇸

New York, New York, United States

Planned Parenthood of New York City - Margaret Sanger Center
🇺🇸New York, New York, United States

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