Second Trimester Labor Induction
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Purpose
A superior second trimester medical abortion regimen has not been identified. Studies suggest that a regimen of mifepristone and misoprostol given 36 to 48 hours apart has the shortest median induction-to-abortion interval, highest 24-hour abortion rate, and low rates of adverse events. Narrowing the interval between the two medications without clinically reducing effectiveness may increase access and acceptability for patients and reduce costs. Data from studies on first trimester abortions suggest that the 6 to 8 hour interval between mifepristone and misoprostol is as efficacious as the 36 to 48 hour interval. There are no studies on shorter intervals with same day administration between mifepristone and misoprostol in second trimester abortions.
The primary objective is to assess the efficacy of the combined mifepristone/misoprostol regimen for abortions between 17 0/7 and 23 6/7 weeks' gestation using an interval of 6 to 8 hours between the two medications.
| Condition | Intervention | Phase |
|---|---|---|
|
Second Trimester Labor Induction |
Drug: Experimental (mifepristone and misoprostol) |
Phase 1 |
| Study Type: | Interventional |
| Study Design: | Endpoint Classification: Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Pilot Study of Mifepristone Followed by Misoprostol in Women Undergoing Second Trimester Abortion |
- Abortion rate [ Time Frame: 8 hours after misoprostol administration ] [ Designated as safety issue: No ]
| Enrollment: | 0 |
| Study Start Date: | March 2008 |
| Estimated Study Completion Date: | October 2010 |
| Estimated Primary Completion Date: | April 2010 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: A
Mifepristone followed by labor induction with misoprostol after 6-8 hours
|
Drug: Experimental (mifepristone and misoprostol)
Mifepristone 200mg followed by labor induction with misoprostol after 6-8 hours
|
Eligibility| Ages Eligible for Study: | 18 Years to 50 Years |
| Genders Eligible for Study: | Female |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- English-speaking women
- 18 years of age and above
- Voluntarily choose to undergo pregnancy termination via labor induction
- An ultrasound-confirmed singleton intrauterine pregnancy between 17 0/7 and 23 6/7 weeks gestation
- Able to provide written consent
Exclusion Criteria:
- Premature rupture of membranes
- Preterm labor
- Intrauterine fetal demise
- Chronic systemic corticosteroid use or adrenal disease
- Hypersensitivity to prostaglandins
- Cardiovascular disease such as angina, valvular disease, arrhythmia, cardiac failure
- Known coagulopathy or treatment with anticoagulants
- Prior caesarean delivery or myomectomy
- Placenta previa
Contacts and Locations| United States, Maryland | |
| Johns Hopkins Hospital | |
| Baltimore, Maryland, United States, 21205 | |
| University of Maryland Medical Center | |
| Baltimore, Maryland, United States, 21201 | |
More Information
No publications provided
| Responsible Party: | Johns Hopkins University |
| ClinicalTrials.gov Identifier: | NCT00592215 History of Changes |
| Other Study ID Numbers: | NA_00010268, 2007-663 |
| Study First Received: | December 31, 2007 |
| Last Updated: | June 9, 2009 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Johns Hopkins University:
|
Second trimester labor induction |
Additional relevant MeSH terms:
|
Mifepristone Misoprostol Contraceptives, Oral, Synthetic Contraceptives, Oral Contraceptive Agents, Female Contraceptive Agents Reproductive Control Agents Physiological Effects of Drugs Pharmacologic Actions Therapeutic Uses Contraceptives, Postcoital, Synthetic |
Contraceptives, Postcoital Hormone Antagonists Hormones, Hormone Substitutes, and Hormone Antagonists Luteolytic Agents Menstruation-Inducing Agents Abortifacient Agents, Steroidal Abortifacient Agents Anti-Ulcer Agents Gastrointestinal Agents Oxytocics Abortifacient Agents, Nonsteroidal |
ClinicalTrials.gov processed this record on May 19, 2013