Mifepristone Versus Osmostic Dilator Insertion for Cervical Preparation Prior to Surgical Abortion at 15-18 Weeks (SaMi2)
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Purpose
In this study the investigators plan to compare mifepristone and misoprostol use to osmotic dilator use for cervical preparation for 15-18 week surgical abortion. Mifepristone would be given 24 hours prior to abortion, and misoprostol 400 mcg would be administered buccally 2 hours prior to abortion. Osmotic dilators are the method currently used in our institution, and are placed 24 hours prior to abortion. The primary outcome will be the length of the procedure. Secondary outcomes will include amount of dilation achieved, ease of procedure, participant's assessment of discomfort after mifepristone or dilators, discomfort during the abortion procedure, acceptability to participants, and acceptability to staff.
| Condition | Intervention | Phase |
|---|---|---|
|
Cervical Preparation |
Drug: Mifepristone Device: osmotic dilators |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Bio-equivalence Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Mifepristone Versus Osmostic Dilator Insertion for Cervical Preparation Prior to Surgical Abortion at 15-18 Weeks |
- Length of procedure [ Time Frame: Subjects will be followed from the administration of mifepristone/misoprostol or laminaria, until the end of their procedure, a total of two days. ] [ Designated as safety issue: No ]Interval from speculum insertion to speculum removal
- Operative time [ Time Frame: Subjects will be followed from the administration of mifepristone/misoprostol, or laminaria, until the end of their procedure, a total of two days. ] [ Designated as safety issue: No ]Interval from initiation of vacuum aspiration to speculum removal
- Cervical dilation at the start of the procedure [ Time Frame: Subjects will be followed from the administration of mifepristone/misoprostol, or laminaria, until the end of their procedure, a total of two days. ] [ Designated as safety issue: No ]
- Patient opinions about the process [ Time Frame: Subjects will be followed from the administration of mifepristone/misoprostol, or laminaria, until the end of their procedure, a total of two days. ] [ Designated as safety issue: No ]
- Provider assessment of the procedure [ Time Frame: Subjects will be followed from the administration of mifepristone/misoprostol, or laminaria, until the end of their procedure, a total of two days. ] [ Designated as safety issue: No ]
- Subject discomfort during the abortion [ Time Frame: Subjects will be followed from the administration of mifepristone/misoprostol, or laminaria, until the end of their procedure, a total of two days. ] [ Designated as safety issue: No ]
- Subject discomfort after the abortion [ Time Frame: Subjects will be followed from the administration of mifepristone/misoprostol, or laminaria, until the end of their procedure, a total of two days. ] [ Designated as safety issue: No ]
- Subject discomfort before the abortion [ Time Frame: Subjects will be followed from the administration of mifepristone/misoprostol, or laminaria, until the end of their procedure, a total of two days. ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 50 |
| Study Start Date: | July 2011 |
| Estimated Study Completion Date: | July 2012 |
| Estimated Primary Completion Date: | July 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Mifepristone + misoprostol
Mifepristone 200 mg PO given 20-24 hours prior to procedure, misoprostol 400 mcg given 2 hours prior to procedure
|
Drug: Mifepristone
200 mg po 20-24 hours prior to the procedure
Other Names:
|
|
Active Comparator: Osmotic dilators
Placed 20-24 hours prior to procedure
|
Device: osmotic dilators
osmotic dilators placed in the cervix 20-24 hours prior to the procedure
Other Names:
|
Eligibility| Ages Eligible for Study: | 18 Years to 50 Years |
| Genders Eligible for Study: | Female |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Women 18-50 years of age undergoing surgical termination of pregnancy
- English or Spanish speaking
- Gestational age between 15 and 18 weeks gestation on day of abortion (inclusive), by ultrasound dating
- Eligible for a dilation and evacuation abortion with local anesthesia and sedation
- Ultrasound for dating purposes done within the last two weeks
Exclusion Criteria:
- Intrauterine infection
- Fetal demise
- Ruptured membranes
- Multiple gestation
- Uterine anomaly or significant distortion of the uterus with fibroids
- BMI greater than 45
- Inability to place osmotic dilators
- Active substance abuse or intoxication
- Adrenal failure, chronic corticosteroid use, anticoagulant usage
- Severe cervicitis, until treated and resolved
- Prior Cesarean section
Contacts and Locations| Contact: Principal Investigator | 617-414-7310 | fpresearch@bmc.org |
| United States, Massachusetts | |
| Boston University | Recruiting |
| Boston, Massachusetts, United States, 02130 | |
| Principal Investigator: | Principal Investigator | Boston University |
More Information
No publications provided
| Responsible Party: | Boston University |
| ClinicalTrials.gov Identifier: | NCT01436279 History of Changes |
| Other Study ID Numbers: | H-31032, AU 6003109 |
| Study First Received: | September 15, 2011 |
| Last Updated: | October 13, 2011 |
| Health Authority: | United States: Institutional Review Board |
Additional relevant MeSH terms:
|
Mifepristone Contraceptives, Oral, Synthetic Contraceptives, Oral Contraceptive Agents, Female Contraceptive Agents Reproductive Control Agents Physiological Effects of Drugs Pharmacologic Actions Therapeutic Uses |
Contraceptives, Postcoital, Synthetic Contraceptives, Postcoital Hormone Antagonists Hormones, Hormone Substitutes, and Hormone Antagonists Luteolytic Agents Menstruation-Inducing Agents Abortifacient Agents, Steroidal Abortifacient Agents |
ClinicalTrials.gov processed this record on June 17, 2013