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Trial registered on ANZCTR
Registration number
ACTRN12616001494426
Ethics application status
Approved
Date submitted
19/09/2016
Date registered
27/10/2016
Date last updated
27/10/2016
Type of registration
Retrospectively registered
Titles & IDs
Public title
Can treatment with nitric oxide donors improve pregnancy outcome in patients with history of unexplained recurrent early pregnancy loss?
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Scientific title
Comparative study between placebo vaginal tablets and the nitric oxide donor isosorbide mononitrate 20 mg tablet applied vaginally for treatment of unexplained recurrent early pregnancy loss
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Secondary ID [1]
290170
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none
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Universal Trial Number (UTN)
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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:
fetal medicine
300445
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complications of pregnancy
300446
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unexplained recurrent early pregnancy loss
300447
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unexplained recurrent early pregnancy loss
300448
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Condition category
Condition code
Reproductive Health and Childbirth
300302
300302
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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
1-.A control group (120 cases) treated with placebo vaginal tablets once daily and a study group (105 cases) treated with isosorbide mononitrate 20 mg tablet applied vaginally once daily.
2-Treatment started from cycle day 21-23 to 12 weeks gestation if pregnancy occurs. If pregnancy does not occur participant repeat treatment next cycle at day 21-23.
3- Adherence to treatment was confirmed by empty drug packet return
4- A control group (120 cases) and a study group (105 cases).
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Intervention code [1]
295928
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Treatment: Drugs
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Intervention code [2]
295929
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Prevention
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Comparator / control treatment
A control group (120 cases) with history of unexplained early recurrent pregnancy loss were treated with microcellulose tablet placebo vaginal tablets starting from cycle day 21-23 and continued till the end of the first trimester if pregnancy occurred
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Control group
Placebo
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Outcomes
Primary outcome [1]
299660
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Take-home baby rate as assessed by review of medical records
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Assessment method [1]
299660
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Timepoint [1]
299660
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End of pregnancy
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Secondary outcome [1]
327765
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Pregnancy loss rate assessed by review of medical records,
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Assessment method [1]
327765
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Timepoint [1]
327765
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Twenty weeks gestation
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Secondary outcome [2]
327766
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Complications of pregnancy assessed by review of medical records
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Assessment method [2]
327766
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Timepoint [2]
327766
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End of pregnancy
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Secondary outcome [3]
327767
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Uterine artery Doppler blood flow indices at cycle day 21-23 before treatment and at 12 weeks gestation
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Assessment method [3]
327767
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Timepoint [3]
327767
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Twelve weeks gestation
Cycle day 21-23
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Eligibility
Key inclusion criteria
The study included 225 patients with the following inclusion criteria: 1- Nulliparous aged 18-30 years, house-wives and nonsmokers. 2- History of two consecutive failed clinical pregnancies from the same husband during the first trimester and confirmed by ultrasound. 3- Normal levels of lupus anticoagulant and anticardiolipin IgG and IgM on two or more occasions at least 12 weeks apart. 4- Normal uterine cavity and no pelvic pathology diagnosed by 3D/4D ultrasound. Hysterography, Sono-hysterography, hysteroscopy and laparoscopy was done in few suspicious cases. 5- Normal blood glucose and hemoglobin A1c levels. 6- Normal serum TSH, serum prolactin and mid luteal phase serum progesterone levels >10 ng/ml. 7- Cytogenetic study of the parents was done for 14 patients who had the third loss during the study and feature no balanced reciprocal translocations.
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Minimum age
18
Years
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Maximum age
30
Years
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Exclusion criteria include patients with cardiac disease, hypertension, sensitivity to NO donors and cases of interim ectopic or molar pregnancy or blighted ovum.
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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)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
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Type of endpoint/s
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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
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Actual
1/01/2013
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Date of last participant enrolment
Anticipated
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Actual
1/01/2014
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Date of last data collection
Anticipated
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Actual
1/01/2016
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Sample size
Target
158
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Accrual to date
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Final
225
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Recruitment outside Australia
Country [1]
8245
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Egypt
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State/province [1]
8245
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Funding & Sponsors
Funding source category [1]
294537
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Hospital
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Name [1]
294537
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Banha University Hospital
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Address [1]
294537
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Farid Nada st. Banha; Kalupia Goernorate; Egypt
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Country [1]
294537
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Egypt
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Primary sponsor type
Hospital
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Name
Banha University Hospital
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Address
Farid Nada St. Banha; Kalupia
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Country
Egypt
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Secondary sponsor category [1]
293408
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None
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Name [1]
293408
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Address [1]
293408
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Country [1]
293408
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
295974
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Ethics committee of the department of OB/GYN
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Ethics committee address [1]
295974
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Banha University Hospital. Banha; Farid Nada St.Kalupia governorate.
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Ethics committee country [1]
295974
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Egypt
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Date submitted for ethics approval [1]
295974
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01/12/2012
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Approval date [1]
295974
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01/12/2012
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Ethics approval number [1]
295974
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NA
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Summary
Brief summary
Objectives: Impairment of endogenous nitric oxide synthesis is claimed a subtle cause of recurrent pregnancy loss. The present study evaluates treatment with the nitric oxide donor isosorbide mononitrate. Methods: Two hundred twenty five nulliparous with history of two consecutive unexplained pregnancy losses during the first trimester were randomized to a control group (120 cases) treated with placebo vaginal tablets and a study group (105) treated with isosorbide mononitrate 20 mg applied vaginally. Treatment started from day 21-23 of the cycle until menstruation and continued if pregnancy occurred until the end of the first trimester. Vaginal color Doppler ultrasound was done before treatment and at 12 weeks gestation to measure uterine artery resistance and pulsation indices. The outcomes of pregnancies in both groups were compared and statistically analyzed. Results: The study group had significant higher take-home baby rate, significant lower pregnancy loss and preeclampsia rates and lower mean uterine artery resistance and pulsation indices at 12 weeks gestation (p<0.05). Conclusions: Treatment of unexplained recurrent pregnancy loss patients with the nitric oxide donor isosorbide mononitrate is associated with better pregnancy outcomes.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
69098
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Prof Mohamed Abdelrazik
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Address
69098
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Department of OB/GYN, Banha University Hospital,; Banha; Farid Nada St. Kalupia governorate,
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Country
69098
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Egypt
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Phone
69098
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+200226070837
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Fax
69098
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Email
69098
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[email protected]
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Contact person for public queries
Name
69099
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Mohamed Abdelrazik
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Address
69099
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Department of OB/GYN, Banha University Hospital, Banha; Farid Nada St.; Kalupia governorate
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Country
69099
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Egypt
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Phone
69099
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+200226070837
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Fax
69099
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NA
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Email
69099
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[email protected]
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Contact person for scientific queries
Name
69100
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Mohamed Abdelrazik
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Address
69100
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Department of OB/GYN, Banha University Hospital; Banha; Farid Nada St. Kalupia governorate
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Country
69100
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Egypt
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Phone
69100
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+200226070837
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Fax
69100
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NA
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Email
69100
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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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