Cervical Ripening Before Endometrial Biopsy in Abnormal Uterine Bleeding Using Sublingual Misoprostol

NCT ID: NCT01762319

Last Updated: 2013-01-07

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

52 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-11-30

Study Completion Date

2013-06-30

Brief Summary

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Abnormal uterine bleeding is common in Thai women. Fractional curettage is an diagnostic procedure of this condition. Traditionally, fractional curettage is performed under local anesthesia such as paracervical nerve block or intravenous meperidine.

Cervical dilatation using "metal cervical dilator" is a common method prior to perform fractional curettage. However, complication from this procedure can be occurred frequently, for example, uterine perforation, false tract formation and laceration of cervix.

Misoprostol is a prostaglandin E1 analogue which is commonly used in obstetrics and gynecology. Misoprostol transforms cervical component causing cervical ripening. This is very helpful for transcervical procedure because cervical dilatation is usually omitted. It can be prescribed in many route and sublingual route is the most effectiveness. Moreover, WHO supports the use of misoprostol in obstetrics and gynecology practice.

The hypothesis of this study is that "Misoprostol 200 micrograms sublingually is effective for cervical ripening before performing fractional curettage in patients with abnormal uterine bleeding" Double blind randomised controlled trial was performed using 26 patients in each group.

Detailed Description

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Conditions

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Abnormal Uterine Bleeding Unrelated to Menstrual Cycle

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Outcome Assessors

Study Groups

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Misoprostol

200 mcg Misoprostol SL 1 hour prior to fractional curettage

Group Type EXPERIMENTAL

Misoprostol

Intervention Type DRUG

Vitamin B6

100 mg Vitamin B6 SL 1 hr prior to fractional curettage

Group Type PLACEBO_COMPARATOR

Vitamin B6

Intervention Type DRUG

Interventions

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Misoprostol

Intervention Type DRUG

Vitamin B6

Intervention Type DRUG

Other Intervention Names

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Cytotec Besix

Eligibility Criteria

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Inclusion Criteria

* thai women at the age over 35 years old
* presenting with abnormal uterine bleeding and have a plan to perform fractional curettage

Exclusion Criteria

* uterine anomalies
* pregnancy
* pelvic inflammatory disease
* uncontrolled medical or psychological conditions
* known cases of gynecological diseases such as gynecological malignancies, abnormal pap smear
* Prostaglandin allergy
* Contraindicate to prostaglandin: asthma, mitral valve stenosis, glaucoma, sickle cell anemia
Minimum Eligible Age

35 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Mahidol University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Korakot Sirimai, MD

Role: PRINCIPAL_INVESTIGATOR

Mahidol University

Locations

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Faculty of Medicine Siriraj Hospital Mahidol University

Bangkok, , Thailand

Site Status RECRUITING

Countries

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Thailand

Central Contacts

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Korakot Sirimai, Dr.

Role: CONTACT

(66)81-6140655

Facility Contacts

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Korakot Sirimai, Dr.

Role: primary

(66)81-6140655

References

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Mittal S, Sehgal R, Aggarwal S, Aruna J, Bahadur A, Kumar G. Cervical priming with misoprostol before manual vacuum aspiration versus electric vacuum aspiration for first-trimester surgical abortion. Int J Gynaecol Obstet. 2011 Jan;112(1):34-9. doi: 10.1016/j.ijgo.2010.07.035. Epub 2010 Nov 26.

Reference Type BACKGROUND
PMID: 21112054 (View on PubMed)

Allen R, O'Brien BM. Uses of misoprostol in obstetrics and gynecology. Rev Obstet Gynecol. 2009 Summer;2(3):159-68.

Reference Type BACKGROUND
PMID: 19826573 (View on PubMed)

Cooper NA, Smith P, Khan KS, Clark TJ. Does cervical preparation before outpatient hysteroscopy reduce women's pain experience? A systematic review. BJOG. 2011 Oct;118(11):1292-301. doi: 10.1111/j.1471-0528.2011.03046.x. Epub 2011 Jul 29.

Reference Type BACKGROUND
PMID: 21797959 (View on PubMed)

Saxena P, Salhan S, Sarda N. Role of sublingual misoprostol for cervical ripening prior to vacuum aspiration in first trimester interruption of pregnancy. Contraception. 2003 Mar;67(3):213-7. doi: 10.1016/s0010-7824(02)00517-6.

Reference Type BACKGROUND
PMID: 12618256 (View on PubMed)

Saxena P, Salhan S, Sarda N. Sublingual versus vaginal route of misoprostol for cervical ripening prior to surgical termination of first trimester abortions. Eur J Obstet Gynecol Reprod Biol. 2006 Mar 1;125(1):109-13. doi: 10.1016/j.ejogrb.2005.07.022. Epub 2005 Sep 1.

Reference Type BACKGROUND
PMID: 16139942 (View on PubMed)

Caliskan E, Filiz T, Yucesoy G, Coskun E, Vural B, Corakci A. Sublingual versus vaginal misoprostol for cervical ripening PRIOR TO manual vacuum aspiration under local anaesthesia: a randomized study. Eur J Contracept Reprod Health Care. 2007 Dec;12(4):372-7. doi: 10.1080/13625180701549758.

Reference Type BACKGROUND
PMID: 17853158 (View on PubMed)

Saha SP, Bhattacharjee N, Baru G. Vaginal Misoprostol for Cervical Priming before Gynaecological Procedures on Non Pregnant Women. Int J Health Sci (Qassim). 2007 Jul;1(2):185-93.

Reference Type BACKGROUND
PMID: 21475427 (View on PubMed)

Boonyarangkul A, Leksakulchai O. Comparison of level of pain between using manual vacuum aspiration and sharp curettage in management of abnormal uterine bleeding. J Med Assoc Thai. 2011 Dec;94 Suppl 7:S57-61.

Reference Type BACKGROUND
PMID: 22619908 (View on PubMed)

Tansathit T, Chichareon S, Tocharoenvanich S, Dechsukhum C. Diagnostic evaluation of Karman endometrial aspiration in patients with abnormal uterine bleeding. J Obstet Gynaecol Res. 2005 Oct;31(5):480-5. doi: 10.1111/j.1447-0756.2005.00324.x.

Reference Type BACKGROUND
PMID: 16176522 (View on PubMed)

Other Identifiers

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SIOGMVA002

Identifier Type: -

Identifier Source: org_study_id

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