Clinical Trial: Misoprostol 400 µg Versus 200 µg for Cervical Ripening in 1st Trimester Miscarriage

Study Status: Recruiting
Recruit Status: Recruiting
Study Type: Interventional

Official Title: Comparison Between 400 µg or 200 µg of Misoprostol for Cervical Dilatation in 1st Trimester Miscarriage - A Clinical Trial

Brief Summary: Local current protocol for cervical ripening in 1st trimester miscarriage recommends 400 µg of misoprostol intravaginally 3 hours before uterine evacuation. This regime has been recommended by some international guidelines . So far, there are no recent studies comparing cervical dilatation between 400 µg of misoprostol and a reduced dose (e.g., 200 µg). If cervical ripening is similar between these two regimens, costs reductions and lower side effects may be issued without losing quality of cervix dilatation.

Detailed Summary:

Miscarriage is defined by the World Health Organization as the interruption of the pregnancy up to 20-23 weeks, or the products of pregnancy weighting less than 500 grams (1). Nearly 15% of known pregnancies end in miscarriage, especially in the first 12 weeks. Estimates indicate that 68000 women die worldwide each year, as a result of unsafe abortions. Abortions are the major cause of maternal death, particularly in Latin America and the Caribbean. In cases of retained and incomplete abortions, uterine emptying is recommended. In the first trimester of pregnancy, either pharmacological or surgical procedure is accepted according to international guidelines.

Pharmacological treatment for uterine evacuation includes the administration of mifepristone and misoprostol or misoprostol alone. Nevertheless, surgical methods has been shown a greater acceptability and patient satisfaction due to a reduced incidence of adverse effects. Currently, Manual Intrauterine Aspiration (MIUA) is the technique recommended by the Brazilian Ministry of Health, and the Brazilian Federation of Gynecology and Obstetrics.

MIUA should be performed after cervical ripening. This pre-surgical procedure makes the procedure safer and more effective. In Brazil, misoprostol is the most suitable drug to be used in these cases because of its efficacy, easy of use, low cost, stability at room temperature and availability. Misoprostol is a synthetic prostaglandin E1 analogue and can be administered by oral, sublingual, buccal, rectal and vaginal routes.

Sponsor: Hospital de Clinicas de Porto Alegre

Current Primary Outcome: Required cervix dilatation to appropriate intrauterine suction [ Time Frame: 1 year ]

Original Primary Outcome: Same as current

Current Secondary Outcome:

Original Secondary Outcome:

Information By: Hospital de Clinicas de Porto Alegre

Dates:
Date Received: November 4, 2016
Date Started: December 21, 2016
Date Completion: December 2017
Last Updated: April 11, 2017
Last Verified: April 2017