Cervical Priming Before Dilation & Evacuation

NCT ID: NCT01597726

Last Updated: 2013-11-07

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

159 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-05-31

Study Completion Date

2013-06-30

Brief Summary

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The purpose of this study is to compare the efficacy of buccal misoprostol cervical priming to laminaria priming among women undergoing D\&E at 13-20 weeks gestation in the Western Cape Province, South Africa

Detailed Description

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As misoprostol is increasingly being used for cervical preparation, concerns about its use and about the proportion of women expelling the fetus prior to the D\&E and other side effects mean that rigorous data on possible advantages of osmotic dilators are needed. To address this gap in the literature, we propose to perform an RCT comparing two methods of cervical preparation prior to D\&E:

1. Misoprostol 400 mcg administered buccally approximately 3-6 hours prior to D\&E, repeated once 3 hours after the first dose (a modified version of the current protocol)
2. Laminaria tents inserted into the cervix 18 to 24 hours prior to D\&E

Conditions

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Abortion, Induced

Keywords

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Abortion, Induced Laminaria Misoprostol Pregnancy Trimester, Second

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Caregivers

Study Groups

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Misoprostol

Group Type ACTIVE_COMPARATOR

Misoprostol

Intervention Type DRUG

Misoprostol 400 mcg administered buccally approximately 3-6 hours prior to D\&E, repeated once 3 hours after the first dose if needed

Laminaria

Group Type EXPERIMENTAL

Laminaria

Intervention Type DEVICE

Laminaria tents inserted into the cervix 18 to 24 hours prior to D\&E

Interventions

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Misoprostol

Misoprostol 400 mcg administered buccally approximately 3-6 hours prior to D\&E, repeated once 3 hours after the first dose if needed

Intervention Type DRUG

Laminaria

Laminaria tents inserted into the cervix 18 to 24 hours prior to D\&E

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Woman seeking TOP between 13 and 20 weeks gestation as determined by ultrasound
* Age 18 or greater
* Willingness to participate in randomized study
* Fluency in English, Afrikaans or Xhosa
* Ability to give informed consent
* Staying within one hour travel time of Tygerberg Hospital for the night prior to the D\&E
* Ability to be contacted by telephone

Exclusion Criteria

* Active cervicitis
* Multiple gestation
* Fetal demise confirmed by ultrasound examination
* History of bleeding disorder or current anticoagulation therapy
* Allergy to misoprostol
* Currently breastfeeding and unwilling or unable to temporarily discard milk
* More than one prior cesarean delivery
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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University of Cape Town

OTHER

Sponsor Role collaborator

Tygerberg Hospital

UNKNOWN

Sponsor Role collaborator

Safe Abortion Action Fund of the International Planned Parenthood Federation

UNKNOWN

Sponsor Role collaborator

Society of Family Planning

OTHER

Sponsor Role collaborator

Ibis Reproductive Health

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Judy Kluge, MBChB

Role: PRINCIPAL_INVESTIGATOR

Tygerberg Hospital

Locations

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Tygerberg Hospital

Cape Town, , South Africa

Site Status

Countries

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South Africa

References

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Constant D, Kluge J, Harries J, Grossman D. An analysis of delays among women accessing second-trimester abortion in the public sector in South Africa. Contraception. 2019 Sep;100(3):209-213. doi: 10.1016/j.contraception.2019.04.009. Epub 2019 Apr 25.

Reference Type DERIVED
PMID: 31029655 (View on PubMed)

Grossman D, Constant D, Lince-Deroche N, Harries J, Kluge J. A randomized trial of misoprostol versus laminaria before dilation and evacuation in South Africa. Contraception. 2014 Sep;90(3):234-41. doi: 10.1016/j.contraception.2014.05.003. Epub 2014 May 14.

Reference Type DERIVED
PMID: 24929888 (View on PubMed)

Related Links

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http://www.ibisreproductivehealth.org/

Click here to visit the Ibis Reproductive Health website

Other Identifiers

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32020

Identifier Type: -

Identifier Source: org_study_id