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WithdrawnNCT01501890Updated Oct 26, 2016

Progesterone for First Trimester Vaginal Bleeding

An interventional study of dihydroxyprogesterone caproate and Placebo in Threatened Abortion, Pre-Eclampsia and Abruptio Placentae, sponsored by Soroka University Medical Center. Withdrawn at 1 site in Israel. Open to female participants aged 16 Years to 45 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2016-10-26.

Sponsored by Soroka University Medical Center · Not applicable, Interventional, and Prevention

Why this study was withdrawn
never started
Phase
Not applicable
Study type
Interventional
Enrollment
0
Allocation
Randomized
Ages
16 Years to 45 Years
Sex
Female
01

Study summary

The purpose of this study is to investigate whether treatment with progesterone for patients with first trimester vaginal bleeding will alter the rates of obstetrical complications and adverse pregnancy outcomes.

Read the detailed description

First trimester vaginal bleeding is one of the most common pregnancy complications affecting 15-25% of all pregnancies. Threatened abortion is defined as bleeding through a closed cervical os in the first half of pregnancy. A subchorionic hematoma (SCH) is found in 18-39% of women with a threatened miscarriage and around 70% of women with a SCH will experience vaginal bleeding. Data on the relationship between first trimester vaginal bleeding and obstetric outcome is described mainly in retrospective and noncontrolled studies. It is hypothesized that first trimester bleeding is an indicator of a general tendency for complications (such as: preterm premature rupture of membranes (PPROM), preterm delivery (\< 37 weeks gestation; PTD) low birth weight (\<1500g; LBW) neonates, small for gestational age (SGA) neonates, placenta previa, placental abruption and stillbirth) later on in pregnancy.

Nowadays, there are not scientific based treatments for the prevention of complications associated with SCH and vaginal bleeding. Nevertheless, recent data have suggested that prophylactic administration of progesterone leads to a significant reduction in the rate of preterm deliveries and SGA neonates among patients with PTD or SGA neonates in the past. Although progesterone administration for threatened miscarriage was not studied, many physicians treat patients with first trimester vaginal bleeding with progesterone. In this era of evidence based medicine, the researchers aim to investigate whether treatment with progesterone for patients with first trimester vaginal bleeding will alter the rates of obstetrical complications and adverse pregnancy outcomes. The researchers hypothesize that treatment with progesterone for first trimester vaginal bleeding will alter the rates of the above mentioned obstetrical complications and adverse pregnancy outcomes.

02

Conditions studied

  • Threatened Abortion
  • Pre-Eclampsia
  • Abruptio Placentae
  • Fetal Growth Retardation
  • Premature Birth

Keywords

  • Threatened Abortion
  • Progesterone
  • Subchorionic Hematoma
  • Pre-Eclampsia
  • Abruptio Placentae
  • Fetal Growth Retardation
  • Premature Birth
03

Who can participate

Ages eligible
16 Years to 45 Years
Sexes eligible
Female
Accepts healthy volunteers
Yes

Inclusion criteria

  • Low risk pregnancies
  • Intrauterine pregnancy documented sonographically
  • Singleton pregnancy
  • Known gestational age
  • Healthy women

Exclusion criteria

Exclusion Criteria:

  • Women after reproductive assistant techniques
  • Women treated with progesterone
  • Multiple pregnancies
04

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Care provider, Investigator)
Enrollment
0 participants (actual)

Study arms

  • Active comparator
    Progesterone

    Women attending the Gynecological Emergency Unit due to first trimester vaginal bleeding, with a viable singleton pregnancy at a gestational age of 6-13 completed weeks of gestation

    Drug: dihydroxyprogesterone caproate

  • Placebo comparator
    Placebo

    Women attending the Gynecological Emergency Unit due to first trimester vaginal bleeding, with a viable singleton pregnancy at a gestational age of 6-13 completed weeks of gestation.

    Drug: Placebo

Interventions

  • Drugdihydroxyprogesterone caproate

    250mg once a week by intramuscular administration

    Also known as: 17a-Hydroxyprogesterone caproate

  • DrugPlacebo

    0.9% NaCl

    Also known as: Sailine, Physiological water

05

What researchers measure

Primary outcomes

  1. adverse pregnancy outcomes

    Miscarriage (also gestational age of miscarriage) Sonographic Intrauterine hematoma IUGR Placenta previa Pregnancy induced hypertension and preeclampsia/eclampsia Gestational age at delivery - Preterm delivery (before 37w); Early Preterm delivery (before 34w); and very early (before 28w) Mode of delivery Placental abruption PPROM Induction of labor PPH Apgar score Umbilical cord blood PH at birth Birth weight Fetal malformations Perinatal mortality Admission to the neonatal unit

    Time frame: 9 months

Secondary outcomes

  1. Uterine artery blood flow velocimetry

    Systolic to diastolic ratio, pulsatility index, resistance index and peak systolic velocity

    Time frame: One month after recruitment upon completion of treatment

  2. Placental pathological examination

    Placental weight and presence of infarcts, calcifications, fibrin deposits or signs of inflammation

    Time frame: After delivey participants will be followed for the duration of hospital stay, an expected average of 3 days

06

Study locations

1 site
  • Soroka University Medical Center
    Beer Sheva, Israel
07

References and documents

Publications

  • Lykke JA, Dideriksen KL, Lidegaard O, Langhoff-Roos J. First-trimester vaginal bleeding and complications later in pregnancy. Obstet Gynecol. 2010 May;115(5):935-944. doi: 10.1097/AOG.0b013e3181da8d38. PubMed 20410766 ↗
08

Registry details

Key details

Study ID
NCT01501890
Lead sponsor
Soroka University Medical Center
Responsible party
Adi Weintraub (Principal Investigator, Soroka University Medical Center) — Principal investigator
First posted
Dec 30, 2011
Start date
Jan 2012
Primary completion
Dec 2013 (estimated)
Completion
Sep 2014 (estimated)
Last update
Oct 26, 2016

Study contacts

Ralika Hershkovitch, MD
principal investigator · Soroka University Medical Center

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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