Pre-Operative Effects of Mifepristone on Dilation and Evacuation Services
Status:
Completed
Trial end date:
2016-06-01
Target enrollment:
Participant gender:
Summary
This research study investigates the use of a drug, mifepristone, given before second
trimester abortion. Mifepristone is a medication that is approved for medical abortion during
the first trimester. It also has been used prior to abortion in the early seconds trimester
(14-16 weeks gestation) and for medication abortion in the second trimester (also called
induction abortion). This medication has effects on the uterus that may help dilate, or open,
the cervix. Abortion requires opening of the cervix to safely remove the pregnancy. Cervical
dilation, or opening, is essential to both ease of completion of procedure and reducing
complications that can occur. These complications include laceration, or tearing, of the
cervix and perforation of the uterus (a hole made unintentionally in the muscle wall of the
uterus) and are not expected to be increased in the study. Dilation of the cervix is usually
achieved by placing thin rods (cervical dilators) through the cervix. These rods then absorb
the moisture of the vagina and slowly expand, opening the cervix. The standard method of
dilation is performed at the clinic and involves the placement of cervical dilators the day
before the procedure. This procedure can be uncomfortable. A prior study showed that
mifepristone reduces the number of osmotic dilators that need to be placed prior to the
procedure after 19 weeks gestation. We aim to investigate mifepristone as a potential adjunct
to cervical dilation or used alone, without dilators, as method of cervical preparation with
the hopes of reducing barriers imposed by painful procedures and time in clinic and away from
work/home that the current approach involving dilators requires.