NCT01862991

Pre-Operative Effects of Mifepristone on Dilation and Evacuation Services

Protocol Title: Reducing Complications and Patient Barriers in Second Trimester Abortion: Pre-Operative Effects of Mifepristone (POEM) on Dilatation and Evacuation Services

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 80 (actual)
• Sponsor: Stanford University · Academic / Other
• Sex: Female
• Age: 18 Years
• Healthy volunteers: Not accepted

Summary

This research study investigates the use of a drug, mifepristone, given before second trimester abortion. Mifepristone is a medication that is approved for medical abortion during the first trimester. It also has been used prior to abortion in the early seconds trimester (14-16 weeks gestation) and for medication abortion in the second trimester (also called induction abortion). This medication has effects on the uterus that may help dilate, or open, the cervix. Abortion requires opening of the cervix to safely remove the pregnancy. Cervical dilation, or opening, is essential to both ease of completion of procedure and reducing complications that can occur. These complications include laceration, or tearing, of the cervix and perforation of the uterus (a hole made unintentionally in the muscle wall of the uterus) and are not expected to be increased in the study. Dilation of the cervix is usually achieved by placing thin rods (cervical dilators) through the cervix. These rods then absorb the moisture of the vagina and slowly expand, opening the cervix. The standard method of dilation is performed at the clinic and involves the placement of cervical dilators the day before the procedure. This procedure can be uncomfortable. A prior study showed that mifepristone reduces the number of osmotic dilators that need to be placed prior to the procedure after 19 weeks gestation. We aim to investigate mifepristone as a potential adjunct to cervical dilation or used alone, without dilators, as method of cervical preparation with the hopes of reducing barriers imposed by painful procedures and time in clinic and away from work/home that the current approach involving dilators requires.

Conditions

• Legally Induced Abortion Without Mention of Complication

Interventions

Type	Name	Description
OTHER	Hygroscopic cervical dilators	Dilapan-S osmotic cervical dilators inserted through the internal os.
DRUG	Misoprostol	400 mcg buccal misoprostol 90 pre-op
DRUG	Intra-amniotic digoxin	1mg digoxin administered intra-amniotically \~24 hours pre-op in patients that are greater than 22 weeks gestation
DRUG	Mifepristone	200 mcg Mifepristone orally

Timeline

• Start date: 2013-07-01
• Primary completion: 2016-06-01
• Completion: 2016-06-01
• First posted: 2013-05-27
• Last updated: 2024-02-14
• Results posted: 2017-06-01

Locations

2 sites across 1 country: United States