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CompletedNCT04604366Updated May 24, 2022

Comparison of Vaginal Versus Sublingual Misoprostol in the Treatment of First Trimester Missed Miscarriage

A Phase 2 interventional study of misoprostol in Miscarriage and Misoprostol, sponsored by Islamabad Medical and Dental College. Completed at 1 site in Pakistan. Open to female participants aged 20 Years to 40 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2022-05-24.

Sponsored by Islamabad Medical and Dental College · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
120
Allocation
Randomized
Ages
20 Years to 40 Years
Sex
Female
01

Study summary

The miscarriage is one of the adverse outcomes of pregnancy and is responsible for stress and anxiety of the couple. there are different types of miscarriages.missed miscarriage also known as early fetal demise is one of the type of miscarriage in which patient is mostly asymptomatic but Ultrasound shows absent fetal cardiac activity.Traditionally surgical evacuation of uterus was the treatment of choice for miscarriage.The treatment of miscarriage has evolved significantly in recent years.medical management using misoprostol is the newest treatment option.Misoprostol is a synthetic prostaglandin E(1) analogue that is commonly used for medical miscarriage It can be given orally, vaginally and sublingually.

Read the detailed description

This study will be conducted in gynae and obstetric department of Akbar Niazi teaching hospital.Patients coming to gynaecology Outpatient department having confirmed diagnosis of missed miscarriage on pelvic ultrasound in first trimester will be enrolled after taking written consent for medical treatment.Patients will be randomly selected for oral or vaginal route of misoprostol,dosage according to international federation of gynaecology and obstetrics protocol.

Vaginal dose---800 microgram 3 hourly two doses Sub lingual 600 microgram 3 hourly two doses Patients will be observed for vaginal bleeding and expulsion for 24 hours if no expulsion or vaginal bleeding occurred then dose will be repeated .maximum of two cycles will be given. Failure of treatment confirmed by Ultrasonography will be dealt with surgical evacuation In case of heavy vaginal bleeding or expulsion pelvic USG will be done to confirm.After admission baseline investigation and coagulation studies will be performed . demographic details will be recorded...

Patients will be assessed for time taken in complete expulsion of conceptus. No of doses required Need for surgical evacuation Haemorrhage Fall in Hb level Need of blod transfusion Patient satisfaction Side effects of misoprostol like shivering,fever diarrhea and oral ulcers and others EXCLUSION CRITERIA patients who opted for surgical management or expectant management. Gestational age >13 weeks Patients with co-morbidity

Sample size: A total of 120 women will be selected for the study, divided into two equal groups of 60 women in each group. The sample size was calculated by WHO sample size calculator with of help of 5% level of significance, 90% power of test, 48% vs. 20% overall complication rate in sub inguinal and vaginal misoprostol groups (???).

Statistical analysis: All the collected data will be entered into SPSS v. 21 for analysis. Quantitative data will be presented in the form of mean ± standard deviation. Independent sample t-test will be applied to compare the quantitative variables (like age and gestational age) between both groups. Frequency with percentages will be calculated for qualitative data and chi-square test will be used to compare the qualitative variables (like abortion and complications) between both groups. P-value ≤ 0.05 will be taken as significant.

02

Conditions studied

  • Miscarriage
  • Misoprostol

Keywords

  • mesoprostol
  • vaginal
  • sublingual
03

Who can participate

Ages eligible
20 Years to 40 Years
Sexes eligible
Female
Accepts healthy volunteers
Yes

Inclusion criteria

  • Confirmed diagnosis of missed miscarriage on pelvic ultrasound
  • Gestational age ≤ 13 weeks

Exclusion criteria

Exclusion Criteria:

  • Patients who opted for surgical or expectant management.
  • Patients with co-morbidity
04

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Participant)
Enrollment
120 participants (actual)

Study arms

  • Active comparator
    vaginal mesoprostol

    Vaginal dose---800 microgram 3 hourly two doses

    Drug: misoprostol

  • Experimental
    sublingual mesoprostol

    Sub lingual 600 microgram 3 hourly two doses

    Drug: misoprostol

Interventions

  • Drugmisoprostol

    it stimulates uterine contractions

    Also known as: prostaglandin E1

05

What researchers measure

Primary outcomes

  1. Number of participants with complete expulsion of conceptus.

    primary outcome measure is to record the number of patients in each group who achieved complete expulsion of products of conception.complete expulsion will be confirmed by pelvic USG

    Time frame: six months

Secondary outcomes

  1. Number of patients having side effects of misoprostol like shivering, fever diarrhea and oral ulcers and others

    through physical examination and detailed history

    Time frame: six months

06

Study locations

1 site
  • Islamabad Medical and Dental College
    Islamabad, Federal 44000, Pakistan
07

References and documents

Publications

  • Dehbashi Z, Moosazadeh M, Afshari M. COMPARISON BETWEEN SUBLINGUAL AND VAGINAL ROUTE OF MISOPROSTOL IN MANAGEMENT OF FIRST TRIMESTER MISCARRIAGE MISSING. Mater Sociomed. 2016 Jul 24;28(4):271-273. doi: 10.5455/msm.2016.28.271-273. PubMed 27698600 ↗

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT04604366
Lead sponsor
Islamabad Medical and Dental College
Responsible party
Afnan Rizwan (Assistant professor, Islamabad Medical and Dental College) — Principal investigator
First posted
Oct 27, 2020
Start date
Nov 2, 2020
Primary completion
Dec 15, 2021
Completion
Dec 31, 2021
Last update
May 24, 2022

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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