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Trial registered on ANZCTR
Registration number
ACTRN12612000150842
Ethics application status
Approved
Date submitted
2/02/2012
Date registered
3/02/2012
Date last updated
28/02/2012
Type of registration
Retrospectively registered
Titles & IDs
Public title
The Medical Management of Miscarriage Study
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Scientific title
The Medical Management of Miscarriage Study: A randomized controlled clinical trial to determine the optimal dose of misoprostol for medical management of miscarriage before 13 weeks
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Secondary ID [1]
279855
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Nil
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Universal Trial Number (UTN)
U1111-1127-8993
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Failed early pregnancy or miscarriage
1984
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Medical Management of Miscarriage
285741
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Condition category
Condition code
Reproductive Health and Childbirth
2081
2081
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0
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Fetal medicine and complications of pregnancy
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Comparison of 2 different doses of misoprostol (400 mcg and 800mcg[control]) administered intravaginally as part of the medical management of recognized miscarriage. The dose of misoprostol is administered at recruitment, and then the following day if the miscarriage is not considered complete. Comparison of efficacy to induce complete miscarriage, side-effect profile and patient tolerance and acceptance is to be determined. The duration of the study is anticipated to be 5 years.
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Intervention code [1]
1005
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Treatment: Drugs
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Comparator / control treatment
The currently recommended dose of 800 mcg Misoprostol intravaginally administered at recruitment, and then the following day if the miscarriage is not considered complete.
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Control group
Dose comparison
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Outcomes
Primary outcome [1]
2901
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Completion of miscarriage - clinical and ultrasound-based assessment
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Assessment method [1]
2901
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Timepoint [1]
2901
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Day 7 - ultrasound criteria
Week 6 - clinical criteria
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Secondary outcome [1]
4923
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Number of visits to hospital /GP due to concern regarding bleeding and pain following administration of misoprostol, assessed using a patient-completed study questionnaire.
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Assessment method [1]
4923
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Timepoint [1]
4923
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at 6 weeks
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Secondary outcome [2]
4924
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Experience of the side effects of the medication, assessed using a patient-completed study questionnaire. The side-effects evaluated include: fever/rigors, nausea, vomiting, diarrhoea, headache, tiredness, infections of the bladder or womb, distress.
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Assessment method [2]
4924
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Timepoint [2]
4924
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at day 3
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Secondary outcome [3]
4925
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Comparison of haemoglobin leaves at enrolment and at follow-up on Day 7, assessed by blood test (full blood count).
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Assessment method [3]
4925
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Timepoint [3]
4925
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at 7 days
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Secondary outcome [4]
4926
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Patient satisfaction with treatment, assessed using a patient-completed study questionnaire.
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Assessment method [4]
4926
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Timepoint [4]
4926
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at 6 weeks
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Eligibility
Key inclusion criteria
1Confirmed failed early pregnancy or incomplete miscarriage of up to 12 completed weeks of pregnancy
2Haemodynamically stable
3Ready access to emergency medical care (lives within 30 minutes of hospital)
4Willingness and consenting to undergo medical management
5Immediate availability of another responsible adult with a driver's license
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1Any suspicion of ectopic pregnancy
2Any features of infection
3Any features suggestive of gestational trophoblastic disease
4Allergy/Sensitivity to misoprostol or similar prostaglandins
5Women in whom prostaglandins would be contraindicated (severe reactive asthma and porphyria)
6Any woman with retained products of conception following a recent termination of pregnancy
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Enrolment - Eligible participants included women presenting with pregnancy loss between 6+0 and 12+6 weeks to the Emergency Department or Early Pregnancy Assessment Unit. Women with ultrasound confirmed incomplete or missed miscarriage (intra-uterine gestational sac with or without a fetal pole) are provided with written information regarding the surgical, expectant or medical management of miscarriage. Women electing medical management and meeting the inclusion criteria will then be offered participation in the study and provide written consent.
Randomization will be performed using a computer generated model with a block size of 6 stratified for study site. After enrolling the women into the study, allocation to the 400 mcg or 800 mcg group will be made by opening the next consecutively numbered, sealed opaque envelope. The allocated dose will be recorded in the medication chart and administered by the non-blinded attending clinicians or nursing staff; the study dose will not be revealed to the participating women who remain blinded throughout the study period.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
computer-generated
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/09/2005
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
300
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Recruitment postcode(s) [1]
4938
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4350
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Funding & Sponsors
Funding source category [1]
284623
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Charities/Societies/Foundations
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Name [1]
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Toowoomba Hospital Foundation
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Address [1]
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Toowoomba Base Hospital
Peechey St
Toowoomba
Qld 4350
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Country [1]
284623
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Australia
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Primary sponsor type
Hospital
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Name
Mater Mother's Hospital
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Address
Raymond Tce
South Brisbane Qld 4101
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Country
Australia
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Secondary sponsor category [1]
2010
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Hospital
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Name [1]
2010
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Toowoomba Base Hospital
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Address [1]
2010
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Toowoomba Base Hospital
Peechey St
Toowoomba
Qld 4350
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Country [1]
2010
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
286616
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Toowoomba Darling Downs Health Service District
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Ethics committee address [1]
286616
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Toowoomba Base Hospital Peechey St Toowoomba Qld 4350
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Ethics committee country [1]
286616
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Australia
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Date submitted for ethics approval [1]
286616
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Approval date [1]
286616
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01/08/2005
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Ethics approval number [1]
286616
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TDDHSD HREC 2005/018
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Ethics committee name [2]
286617
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Mater Health Services
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Ethics committee address [2]
286617
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Mater Health Services Raymond Tce South Brisbane Qld 4101
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Ethics committee country [2]
286617
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Australia
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Date submitted for ethics approval [2]
286617
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Approval date [2]
286617
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01/05/2007
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Ethics approval number [2]
286617
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MHS HREC 976M
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Summary
Brief summary
The optimal dose of Misoprostol to be used in the medical management of miscarriage before 13 weeks has not been resolved. This study was undertaken to evaluate the effectiveness and side effect profile of two different dosages of Misoprostol. Methods A randomized controlled, equivalence study comparing 400mcg vs 800mcg Misoprostol per vaginum (PV) on an outpatient basis. The allocated dose was repeated the next day if clinically the products of conception had not been passed. Complete miscarriage was evaluated using two methods: ultrasound criteria on Day 7; and the need for surgical management (clinical criteria). Equivalence was demonstrated if the 95% confidence interval [CI] of the observed risk difference between the two doses for complete miscarriage lay between -15.0% and 15.0%. Differences in side effects and patient satisfaction were evaluated using patient-completed questionnaires.
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Trial website
not applicable
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Trial related presentations / publications
nil
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Public notes
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Contacts
Principal investigator
Name
36135
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Address
36135
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Country
36135
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Phone
36135
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Fax
36135
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Email
36135
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Contact person for public queries
Name
10194
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Scott G Petersen
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Address
10194
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Mater Mother's Hospital
Raymond Tce
South Brisbane Qld 4101
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Country
10194
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Australia
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Phone
10194
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+61 7 31638111
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Fax
10194
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Email
10194
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[email protected]
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Contact person for scientific queries
Name
1122
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Scott G Petersen
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Address
1122
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Mater Mother's Hospital
Raymond Tce
South Brisbane Qld 4101
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Country
1122
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Australia
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Phone
1122
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+61 7 31638111
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Fax
1122
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Email
1122
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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