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Outpatient Service for Mid-trimester Termination of Pregnancy

Phase 4
Completed
Conditions
Abortion in Second Trimester
Interventions
Registration Number
NCT03346629
Lead Sponsor
Gynuity Health Projects
Brief Summary

This study seeks to evaluate the safety, acceptability and feasibility of an outpatient "day procedure" for medical abortion at 13-18 weeks gestation. The study regimen will consist of a single dose of 200 mg mifepristone to be taken orally either at home or at the hospital, followed approximately 24 - 48 hours later with administration of 400 mcg misoprostol. Repeat doses of 400 mcg (two tablets) of misoprostol will be administered buccally every three hours until the abortion is achieved.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
230
Inclusion Criteria
  • Have an ongoing pregnancy of 13-18 weeks gestation
  • Meet legal criteria to obtain an abortion at 13-18 weeks gestation (legal criteria include pregnancy resulting from rape or incest, fetal malformation and/or if the pregnancy affects the physical or mental health of the woman)
  • Has access to a phone where she can be reached at the 2-week follow-up
  • Be willing to follow study procedures
Exclusion Criteria
  • Known allergy to mifepristone or misoprostol/prostaglandin or other contraindications to the use of mifepristone or misoprostol
  • Any contraindications to vaginal delivery
  • More than one prior cesarean delivery
  • Living more than 2 hours away from the hospital

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Mifepristone + MisoprostolMifepristone + MisoprostolIntervention: 200mg mifepristone followed 24-48 h later with 400mcg misoprostol (repeat Q3)
Primary Outcome Measures
NameTimeMethod
Successful medical abortion0 - 48 hours after first dose of mifepristone

Proportion of women who have a successful medical abortion without recourse to surgical intervention and return home on the same day as misoprostol induction

Secondary Outcome Measures
NameTimeMethod
Total dose of misoprostol0 - 48 hours after first misoprostol dose

Average number of doses of misoprostol

Safety - Proportion of participants who experience at least one of the following: extramural delivery, hemorrhage requiring transfusion, infection, uterine rupture, prolonged hospitalization, any complications2 weeks after initial visit

Proportion of participants who experience at least one of the following: extramural delivery, hemorrhage requiring transfusion, infection, uterine rupture, prolonged hospitalization, any complications

Hospital admission timeWithin 0 - 48 hours after the second dose of misoprostol

Average total hospital admission time

Induction-to-abortion interval0 - 48 hours after first misoprostol dose

Median time elapsed between administration of the first misoprostol dose until expulsion of both fetus and placenta

Tasks performed by certified staff0 - 72 hours after receipt of mifepristone

Type of task performed (i.e. counseling, monitoring vital signs, administering drugs, monitoring woman's condition, post-abortion contraception, managing discharge)

Side Effects0 - 48 hours after first dose of misoprostol

Proportion of participants experiencing side effects (severity incidence, and severity of pain based on a 0-10 point scale)

Initiation-to-abortion interval0 - 72 hours after receipt of mifepristone

Median time elapsed between administration of the mifepristone dose until expulsion of both fetus and placenta

Trial Locations

Locations (3)

Kathmandu Model Hospital

🇳🇵

Kathmandu, Nepal

Kathmandu Medical College

🇳🇵

Kathmandu, Nepal

KIST Medical College, Teaching Hospital

🇳🇵

Imadol, Lalitpur, Nepal

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