Cervical Ripening in Postmenopausal Women

NCT ID: NCT02534883

Last Updated: 2018-07-12

Basic Information

• Recruitment Status: TERMINATED
• Clinical Phase: NA
• Total Enrollment: 11 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2015-08-31
• Study Completion Date: 2016-12-31

Brief Summary

Misoprostol (Cytotec) 200ug vaginally will be given to patients 12 hours and 2 hours pre-operatively (before surgery) for a total of 400ug to ripen, soften or relax the cervix for dilation (opening). This is to assist with the insertion of a hysteroscope (the surgical instrument) into the uterus for all operative hysteroscopic procedures requiring dilation above 5 mm.

Time required for cervical dilatation will be recorded. Start time will be when the smallest dilator is placed into the endocervical canal, and stop time recorded when the desired cervical dilation is achieved with the largest dilator. Depending on the procedure, desired dilation may range between 5-10mm. Time will serve as a surrogate for operative ease of dilatation.

The investigators will compare the two groups in terms of medication, resistance, dilation time and size, side effects and surgical complications.

Detailed Description

This study will be a randomized, double blinded, placebo controlled trial.

Patients will be assigned by chance to receive 200ug of misoprostol or placebo (empty gelatin capsule) vaginally twice (for a total of 400ug). There is no standard of care, but to receive misoprostol or not are both accepted practices and that Standard of Care is for the clinicians to use clinical judgment .

Patients will be randomized to one of the following treatment regimens:

Group 1 will received 200ug of misoprostol, to be placed into the posterior vaginal fornix 12 hours and 2 hours before their scheduled surgery (a total of 400ug of misoprostol). St. Mary's pharmacy will prepare capsules with each containing 200ug of misoprostol.

Group 2 will received placebo (empty gelatin capsule), to be placed into the posterior vaginal fornix 12 hours and 2 hours before their scheduled surgery.

The two groups, will be compared in terms of side effects, resistance, dilation time, size and surgical complication.

Randomization will occur using a computer program called Research Randomizer, http://www.randomizer.org/form.htm. A set of 100 non-unique numbers will be randomized. Once the randomization list is generated, envelopes will be made. Based on the randomizer results a folder slip of paper with the treatment (misoprostol or placebo) written on it will be placed in sequential numbered envelopes. The number on the envelope will be the patients code number. An unblinded member of the research team will open the randomized envelope, and log into a master drug log the randomization.

The medication and/or placebo will be place in numbered sequentially bottles with a master drug log containing which is misoprostol and which is placebo. Each bottle will have child proof lids for dispensing and will be labeled misoprostol 200ug/each/placebo), physician name (Ward) and contact number, and "For investigational use only" will also be noted.

The unblinded staff will notify the research member consenting the patient and inform them of what number bottle to give to the patient, in the office before surgery

Conditions

Stenosis of Cervix

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: TRIPLE

Study Groups

Group 1

Group 1 will received 200ug of misoprostol, to be placed into the posterior vaginal fornix 12 hours and 2 hours before their scheduled surgery (a total of 400ug of misoprostol).

Group Type: ACTIVE_COMPARATOR

Misoprostol

Intervention Type: DRUG

To be place vaginally

Group 2

Group 2 will received placebo (empty gelatin capsule), to be placed into the posterior vaginal fornix 12 hours and 2 hours before their scheduled surgery.

Group Type: PLACEBO_COMPARATOR

Placebo

Intervention Type: DRUG

To be placed vaginally

Interventions

Misoprostol

To be place vaginally

Intervention Type: DRUG

Placebo

To be placed vaginally

Intervention Type: DRUG

Other Intervention Names

Cytotec; non active drug

Eligibility Criteria

Inclusion Criteria

• 45-80yrs of age
• Postmenopausal (amenorrhea for greater than 1 year)
• May or may not be using hormone replacement therapy
• Scheduled or to be scheduled for hysteroscopy/resectoscopy procedures

Exclusion Criteria

• Pregnant
• Known Cancer
• Known hypersensitivity to prostaglandins.
• Those who are breastfeeding

• Minimum Eligible Age: 45 Years
• Maximum Eligible Age: 85 Years
• Eligible Sex: FEMALE
• Accepts Healthy Volunteers: No

Sponsors

St. Louis University

OTHER

Sponsor Role: lead

Responsible Party

Donald Gregory Ward, M.D.

MD

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Donald Ward, MD

Role: PRINCIPAL_INVESTIGATOR

St. Louis University

Locations

St. Mary's Health Center

St Louis, Missouri, United States

Countries

United States

Other Identifiers

25065

Identifier Type: -

Identifier Source: org_study_id