Comparison of Laminaria and Misoprostol for Cervical Preparation Before Second Trimester Surgical Abortion
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Purpose
This study compares the effectiveness of cervical preparation before second trimester abortion using laminaria versus vaginal Misoprostol.
The investigators hypothesize that medical preparation of the cervix with vaginal Misoprostol is superior to mechanical preparation using laminaria.
The investigators believe that medical preparation makes the procedure easier to perform, equally safe, without addition of pain or discomfort.
| Condition | Intervention |
|---|---|
|
Induced; Abortion, Nonmedical |
Device: Laminaria, MedGyn Products, Inc. USA. Drug: Misoprostol |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Randomized Controlled Study: Comparison of Laminaria and Misoprostol for Cervical Preparation Before Second Trimester Surgical Abortion |
- Initial cervical opening and the need for further dilatation at the start of the procedure [ Time Frame: 8-12 hours after insersion of laminaria or Misoprostol ] [ Designated as safety issue: Yes ]The surgical abortion will be performed 8-12 hours after the insertion of laminaria, or after vaginal application of Misoprostol
- pain score during cervical preparation and after the procedure [ Time Frame: at the time of the insertion, immediately before the abortion and immediately upon recovery from anesthesia ] [ Designated as safety issue: No ]
The pain score will be accessed immediately after the insertion of the laminaria or the vaginal Misoprostol.
Pain score will be recorded again right before performing the abortion and will address the 8-12 hours elapsed from the insertion.
Another assessment of pain will be recorded immediately after the abortion following recovery from general anesthesia
- The degree of difficulty to accomplish the abortion [ Time Frame: at the time of performing the surgical abortion ] [ Designated as safety issue: No ]The difficulty score will be recorded by the surgeon at the operating room immediately upon completion of the procedure.
| Enrollment: | 84 |
| Study Start Date: | November 2007 |
| Study Completion Date: | June 2010 |
| Primary Completion Date: | June 2010 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Laminaria group
Patients in this group will have cervical preparation with laminaria MedGyn Products, Inc. USA overnight the day before the abortion
|
Device: Laminaria, MedGyn Products, Inc. USA.
Insertion of Hygroscopic laminarias into the cervical canal for preparation prior to late surgical abortion. The number of laminarias is according to the cervical compliance.
Other Name: laminaria tents
|
|
Active Comparator: Misoprostol group
Patients in this group will have cervical preparation with vaginal Misoprostol 600 mcg overnight the day before the abortion
|
Drug: Misoprostol
Cervical preparation with vaginal Misoprostol 600 mcg overnight the day before the abortion
Other Name: Cytotec
|
Detailed Description:
This is a prospective randomized study.
The aim of the study is to compare preparation of the cervix before surgical abortion with laminaria and misoprostol.
Primary outcome measures will include:
Initial cervical opening and the need for further dilatation at the procedure Procedure duration
Difficulty score performing the abortion
Complications during and after the procedure
Assessment of pain, using VAS scale, and the need for analgesia before and after the procedure
Eligibility| Ages Eligible for Study: | 15 Years to 45 Years |
| Genders Eligible for Study: | Female |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Pregnant patients with a viable singleton
- Pregnancy 14-20 weeks of gestation
- Admitted for termination of pregnancy
Exclusion Criteria:
- Contraindication for administration of Misoprostol
- Patients with more than one previous cesarean section scar
- Patients with impaired coagulation
- Significant pulmonary or cardiac disease
- Non viable pregnancy
- Placenta accreta or previa by ultrasound
Contacts and Locations
More Information
No publications provided
| Responsible Party: | Wolfson Medical Center |
| ClinicalTrials.gov Identifier: | NCT01678703 History of Changes |
| Other Study ID Numbers: | 2trimabort.CTIL |
| Study First Received: | August 22, 2012 |
| Last Updated: | August 30, 2012 |
| Health Authority: | Israel: Ministry of Health |
Keywords provided by Wolfson Medical Center:
|
late abortion laminaria Misoprostol Cervical preparation |
Additional relevant MeSH terms:
|
Misoprostol Anti-Ulcer Agents Gastrointestinal Agents Therapeutic Uses Pharmacologic Actions |
Oxytocics Reproductive Control Agents Physiological Effects of Drugs Abortifacient Agents, Nonsteroidal Abortifacient Agents |
ClinicalTrials.gov processed this record on May 19, 2013