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Value of Mifepristone in Cervical Preparation Prior to Dilation and Evacuation 19-24 Weeks

Not Applicable
Completed
Conditions
Abortion, Induced
Interventions
Registration Number
NCT01615731
Lead Sponsor
Stanford University
Brief Summary

A common practice for preparation for surgical abortion after 19 weeks gestation is the placement of multiple sets of osmostic dilators 1-2 days prior to the procedure. The investigators aim to study the addition of mifepristone as an adjunct to cervical dilation prior to abortion between 19-24 weeks gestation, and its potential to minimize the number of painful procedures and time in clinic (or away from work/home) that multiple sets of dilators can require. The investigators hypothesize that one set of dilators with mifepristone will result in similar procedure times and decreased "total" time as two sets of dilators.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
50
Inclusion Criteria
  • >18 years old
  • Viable, Singleton pregnancy
  • Voluntarily seeking abortion between 19 and 24wks gestation
  • Able to give informed consent and comply with study protocol
  • Fluent in English or Spanish
Exclusion Criteria
  • Allergy to misoprostol or mifepristone

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Two sets of dilatorsMisoprostolTwo sets of osmotic dilators inserted 1 and 2 days pre-op
Two sets of dilatorsIntra-amniotic digoxinTwo sets of osmotic dilators inserted 1 and 2 days pre-op
Two sets of dilatorsHygroscopic cervical dilatorsTwo sets of osmotic dilators inserted 1 and 2 days pre-op
Mifepristone plus one set of dilatorsIntra-amniotic digoxinOne set of dilators plus mifepristone
Mifepristone plus one set of dilatorsHygroscopic cervical dilatorsOne set of dilators plus mifepristone
Mifepristone plus one set of dilatorsMifepristoneOne set of dilators plus mifepristone
Mifepristone plus one set of dilatorsMisoprostolOne set of dilators plus mifepristone
Primary Outcome Measures
NameTimeMethod
Total Procedure TimeMeasured at clinic visits and on OR day, over a 3 day period
Procedure TimeIntraoperative Time

Measured as time from speculum insertion to removal

Secondary Outcome Measures
NameTimeMethod
Overall Patient ExperienceMeasured post operatively (at least 30 minutes, on average 1.5 hours) prior to discharge

Used a Visual Analogue Scale to determine the patient's overall satisfaction with her experience. The VAS ranges from 0-100. 0 being a worse than expected experience, 50 being what the patient expected and 100 being a better than expected experience.

Adverse Events (EBL)Intraoperatively

One adverse event: Estimated Blood Loss

Ease of Procedure by Blinded SurgeonMeasured Immediately after procedure

Used a Visual Analogue Scale to determine the ease of procedure by blinded surgeon. The VAS ranges from 0-100. 0 being the easiest procedure the surgeon felt they had every performed and 100 being the most difficult procedure imaginable by the surgeon.

Maximum Cervical DilationMeasured intra-operatively

Measured by estimate with bimanual exam and passage of largest dilator immediately prior to procedure.

Pain Perceived by PatientMeasured pre-operatively (after misoprostol, immediately before transport to OR) and post-operatively (in recovery room, on average 1.5 hours post-operatively)

Used a Visual Analogue Scale to determine the pain perceived by the patient pre-operatively (after misoprostol, immediately before transport to OR) and post-operatively (in recovery room, on average 1.5 hours post-operatively). The VAS ranges from 0-100. 0 being no pain felt by the patient and 100 being the worst pain imaginable felt by the patient.

Adverse EventsIntraoperatively and 2 weeks post operatively

uterine perforation, uterine injury, etc.

Trial Locations

Locations (2)

Santa Clara Valley Medical Center

🇺🇸

San Jose, California, United States

Stanford University Medical Center

🇺🇸

Stanford, California, United States

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