Termination of Pregnancy in Previous Scarred Uterus: PGE1 Versus Cervical Folleys

May 17, 2026 updated by: Dr Mudassar Saeed Pansota

Comparison of the Efficacy of PGE1 Versus Cervical Folleys in Termination of Pregnancy in Previous Scarred Uterus

As mentioned above, previous studies have shown variable results and the best among these two is still in debate, so there must be re-evaluation of results on this topic. The rationale of this study is to compare the efficacy (in terms of complete evacuation) of PGE1 versus cervical folleys in termination of pregnancy. This study not only will lead to the decision regarding selection of appropriate method with less comorbidities but also add in the literature regarding the women health improvement that is a matter of concern in 21st century. Then based on the results of my study, these particular patients can be provided with better way of second trimester termination of pregnancy in order to reduce the complications of the incomplete miscarriage as well as morbidity and mortality of these patients

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Among unintended 205 million pregnancies that occur each year worldwide, about 20% of them end in induced abortion. Majority of these abortions occur during the first trimester of pregnancy. The second trimester of pregnancy is subdivided into an early period between 13-20 weeks and a late period between 20-28 weeks. Advanced screening techniques have led to an increase in the detection of congenital malformations with subsequent gradual increase in second trimester termination of pregnancy which represents 10-15% of total abortions performed worldwide. Termination in the second trimester is more risky than during first trimester. So the pharmacologic management seems to be an appealing alternative to surgical evacuation.

There is a wide range of prostaglandin preparations available which can be used for cervical ripening or induction of labour. Misoprostol is a synthetic prostaglandin E1 analogue. It was first used in obstetrics to induce abortion in 1988. Now it is widely used for induction of labour, termination of pregnancy and management of postpartum haemorrhage but still its use in obstetrics is not approved by FDA. Mechanical dilatation of cervix to induce abortion or labour is also known since 1833. The Foleys catheter traction is the cheapest, safest and successful mechanical method of cervical dilatation according to various studies. The decision regarding the effectiveness of any of the above two modality in women with previous cesarean is still a debate

Study Type

Interventional

Enrollment (Actual)

60

Phase

  • Phase 4

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Pakistan
    • Punjab Province
      • Faisalabad, Punjab Province, Pakistan, 60000
        • Hilal-e-ahmar Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • All women presented for termination of pregnancy (as per-operational definition).
  • Patients with age 20-45 years

Exclusion Criteria:

  • Women having multiple gestation.
  • Women having any complication of miscarriage like bleeding, chorioamnionitis, disseminated intravascular coagulopathy.
  • Women having any complication in previous cesarean like endometritis, re opening and scar dehiscence.
  • Patients with molar or ectopic pregnancy (assessed on ultrasonography).

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: PGE1
Group A will receive 200µg orally five doses six hours apart. If the patient did not abort after the first course, the same regimen will be repeated 24 hours after the start of the first dose of misoprostol
Drug: PGE1 tablet
Group A will receive 200µg orally five doses six hours apart. If the patient did not abort after the first course, the same regimen will be repeated 24 hours after the start of the first dose of misoprostol
Active Comparator: cervical folleys
Group B will receive cervical foleys. Foley's catheter group will be put in lithotomy position in examination room, vulva vagina will be cleaned with pyodine and sterile Sim's speculum will be introduced in the vagina, holding anterior cervical lip with sponge holding forceps and with the help of another sponge holding forceps a Foleys catheter no 14 Fr will be passed in the cervix into the extra amniotic space and balloon will be inflated with 30ml saline. A urine bag will be filled with 500ml saline will be attached to the catheter for traction. As soon as the catheter will be expelled reassessment of the dilatation of the cervix will be done and if needed infusion oxytocin will be started
Device: cervical folleys
Group B will receive cervical foleys. Foley's catheter group will be put in lithotomy position in examination room, vulva vagina will be cleaned with pyodine and sterile Sim's speculum will be introduced in the vagina, holding anterior cervical lip with sponge holding forceps and with the help of another sponge holding forceps a Foleys catheter no 14 Fr will be passed in the cervix into the extra amniotic space and balloon will be inflated with 30ml saline. A urine bag will be filled with 500ml saline will be attached to the catheter for traction. As soon as the catheter will be expelled reassessment of the dilatation of the cervix will be done and if needed infusion oxytocin will be started

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Percentage of efficacy
Time Frame: 48 hours
It refers to the ability of PGE1 or cervical Foleys to achieve complete abortion within 48 hours during the second trimester of fetal demise
48 hours

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Dr Mudassar Saeed Pansota

Investigators

  • Principal Investigator: Atiqa Noreen, Hilal-e-Ahmar Hospital, Faisalabad

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

November 13, 2025

Primary Completion (Actual)

April 12, 2026

Study Completion (Actual)

May 12, 2026

Study Registration Dates

First Submitted

May 17, 2026

First Submitted That Met QC Criteria

May 17, 2026

First Posted (Actual)

May 22, 2026

Study Record Updates

Last Update Posted (Actual)

May 22, 2026

Last Update Submitted That Met QC Criteria

May 17, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • Hilal-e-Ahmer Hospital

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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