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Cost-utility Analysis of Outpatient Manual Vacuum Aspiration Versus Operating Room Electric Aspiration for the Management of First-trimester Miscarriage (ASPIR)

2026년 7월 27일 업데이트: Nantes University Hospital

Cost-utility Analysis of Outpatient Manual Vacuum Aspiration Versus Operating Room Electric Aspiration for the Management of First-trimester Miscarriage (ASPIR Study)

The ASPIR study aims to evaluate the cost-utility of outpatient manual vacuum aspiration compared with operating room electric aspiration for the management of first-trimester miscarriage. It is hypothesized that manual aspiration will demonstrate equivalent clinical efficacy and patient quality of life while reducing healthcare costs.

연구 개요

상태

아직 모집하지 않음

정황

개입 / 치료

상세 설명

Miscarriage occurs in approximately 15% of pregnancies during the first trimester. In France, surgical management usually involves electric aspiration in the operating room under anesthesia, associated with hospital admission. Manual vacuum aspiration (MVA) is widely used in low-resource settings and for induced abortion, with demonstrated safety and patient satisfaction. This multicenter randomized controlled trial compares outpatient MVA under local anesthesia and inhaled analgesia versus electric aspiration (EA) under anesthesia in the operating room.

The primary objective is to assess the incremental cost-utility ratio (ICUR, cost per QALY) at 3 months. Secondary outcomes include complications, pain, satisfaction, quality of life, and fertility at 12 months. The study anticipates enrolling 860 participants across multiple centers in France.

연구 유형

중재적

등록 (추정된)

860

단계

  • 해당 없음

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 연락처

연구 장소

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

  • 성인

건강한 자원 봉사자를 받아들입니다

아니

설명

Inclusion Criteria:

  • Female, aged 18-44 years
  • Ultrasound-confirmed first-trimester miscarriage requiring surgical management
  • Gestational age between 5 and 12 weeks of amenorrhea
  • Incomplete spontaneous abortion or ongoing non-viable pregnancy
  • Patient able to provide oral informed consent

Exclusion Criteria:

  • Complete expulsion of pregnancy (endometrial thickness < 15 mm)
  • Choice of medical treatment with misoprostol
  • Elective termination of pregnancy
  • Unwanted pregnancy
  • Pregnancy of unknown location, molar pregnancy
  • Known uterine malformation
  • Prior surgical aspiration for the current pregnancy
  • Intrauterine device in place
  • Contraindicating medications (e.g. anticoagulants)
  • Protected adults (under guardianship)
  • Inability to complete study questionnaires
  • Lack of social security coverage
  • Haemorrhagic miscarriage

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

  • 주 목적: 건강 서비스 연구
  • 할당: 무작위
  • 중재 모델: 병렬 할당
  • 마스킹: 없음(오픈 라벨)

무기와 개입

참가자 그룹 / 팔
개입 / 치료
실험적: Manual vacuum aspiration (MVA)
Outpatient manual vacuum aspiration under local anesthesia and inhaled analgesia (MEOPA).
절차: Manual vacuum aspiration (MVA)
Performed in consultation under local anesthesia and inhaled analgesia, using a manual vacuum aspirator and appropriate cannula. Post-procedure pelvic ultrasound to confirm complete evacuation.
활성 비교기: Electric aspiration in the operating room under general or regional anesthesia. Electric aspiration
Electric aspiration in the operating room under general or regional anesthesia. Performed in the operating room under general or regional anesthesia, using an electric suction device and appropriate cannula. Post-procedure pelvic ultrasound to confirm complete evacuation.
절차: Electric aspiration (EA)
Performed in the operating room under general or regional anesthesia, using an electric suction device and appropriate cannula. Post-procedure pelvic ultrasound to confirm complete evacuation.

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
Incremental cost-utility ratio (ICUR)
기간: 3 months
Incremental cost per quality-adjusted life year (QALY) gained of outpatient MVA compared to operating room EA, from a collective perspective.
3 months

2차 결과 측정

결과 측정
측정값 설명
기간
Annual net financial benefit for health insurance over up to 5 years of different development scenarios for manual vacuum aspiration in consultation for the management of pregnancies terminated before 12 weeks of gestation
기간: up to 5 years
Annual net financial benefit for health insurance over up to 5 years of different development scenarios for manual vacuum aspiration in consultation for the management of pregnancies terminated before 12 weeks of gestation
up to 5 years
To compare the two management strategies in terms of success and intraoperative and postoperative complications
기간: 1 month

To compare the two management strategies in terms of success and intraoperative and postoperative complications

  • 2.1 Management failure defined by the need for second-line treatment (aspiration, misoprostol, etc.)
  • 2.2 Intraoperative complications: change of strategy, bleeding greater than 200 ml, uterine perforation, etc., and all possible complications classified according to the Clavien and Dindo criteria
  • 2.3 Trophoblastic retention image defined by retention (heterogeneous intrauterine mass independent of the endometrium) greater than 20 mm thick on transvaginal ultrasound at M1.
1 month
To assess patient satisfaction
기간: day 1 and 2

To assess patient satisfaction:

A numerical scale (NS) (0-10) on Days 1 and 2.
day 1 and 2
To compare the two strategies (electric suction versus manual vacuum kit suction)
기간: days 0, 1,7 and 1 and 3 months

To compare the two strategies (electric suction versus manual vacuum kit suction), measurement of:

●Pain via NS (a scale from 0 to 10) on Day 0 (before the procedure, 30 min after the procedure +/- 30 min), Days 1, 7, 1, and 3
days 0, 1,7 and 1 and 3 months
The risk factors for failure
기간: 3 months
The risk factors for failure at M3 studied will be: the term of the terminated pregnancy, patient compliance, patient satisfaction (numerical scale (from 0 to 10), patient characteristics (age).
3 months
Satisfaction with the patient's care by medical staff
기간: day 0 and 1 month
Satisfaction with the patient's care by medical staff will be assessed using an EN (numerical scale 0 to 10) at D0 and M1
day 0 and 1 month
Patient having been pregnant in days
기간: 12 months
Patient having been pregnant at 12 months, pregnancy outcome and time to conception in days.
12 months
To assess patient satisfaction
기간: day 1 and 2 and 1 month et 3 month

To assess patient satisfaction:

A numerical scale (NS) (0-10) on Days 1 and 2. HADS (Hospital Anxiety and Depression Scale) and PCL-5 questionnaires at 1 and 3 months
day 1 and 2 and 1 month et 3 month
To assess patient satisfaction
기간: 1 and 3 months
HADS (Hospital Anxiety and Depression Scale) and PCL-5 questionnaires at 1 and 3 months
1 and 3 months
To compare the two strategies (electric suction versus manual vacuum kit suction)
기간: Day 0, 1,7 and 1 and 3 months

To compare the two strategies (electric suction versus manual vacuum kit suction), measurement of:

●Pain via NS (a scale from 0 to 10) on Day 0 (before the procedure, 30 min after the procedure +/- 30 min), Days 1, 7, 1, and 3
Day 0, 1,7 and 1 and 3 months
To compare the two strategies (electric suction versus manual vacuum kit suction)
기간: Day 0 to 7

To compare the two strategies (electric suction versus manual vacuum kit suction), measurement of:

●Analgesic consumption (type, quantity, and duration) from Day 0 to 7
Day 0 to 7
To compare the two strategies (electric suction versus manual vacuum kit suction)
기간: Day 0 to 7

To compare the two strategies (electric suction versus manual vacuum kit suction), measurement of:

●Number of pads used per day (Higham score) from Days 1 to 7
Day 0 to 7
To compare the two strategies (electric suction versus manual vacuum kit suction)
기간: Day 0

To compare the two strategies (electric suction versus manual vacuum kit suction), measurement of:

  • Duration of the procedure in minutes
  • Waiting time for therapeutic treatment in minutes
  • Time spent in hospital in minutes
Day 0
To compare the two strategies (electric suction versus manual vacuum kit suction)
기간: 1 and 3 months

To compare the two strategies (electric suction versus manual vacuum kit suction)

● Postoperative complications will include:Perioperative bleeding greater than 200 ml (Higham score), infection (temperature >38°C and pelvic symptoms) …classified according to the Calvien and Dindo criteria, at M1, the persistence of abnormal bleeding, trophoblastic retention, at M3, the presence of amenorrhea outside the context of a new pregnancy
1 and 3 months
To compare the two strategies (electric suction versus manual vacuum kit suction)
기간: 1 et 3 months

To compare the two strategies (electric suction versus manual vacuum kit suction), measurement of:

●quality of life questionnaires EQ-5D-5L, PGI-I at M1 and M3
1 et 3 months

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

스폰서

Nantes University Hospital

수사관

  • 수석 연구원: Thibault Thubert, Pr, Nantes university hospital

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작 (추정된)

2026년 10월 1일

기본 완료 (추정된)

2027년 1월 1일

연구 완료 (추정된)

2029년 10월 1일

연구 등록 날짜

최초 제출

2026년 5월 28일

QC 기준을 충족하는 최초 제출

2026년 7월 27일

처음 게시됨 (실제)

2026년 7월 28일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2026년 7월 28일

QC 기준을 충족하는 마지막 업데이트 제출

2026년 7월 27일

마지막으로 확인됨

2026년 7월 1일

추가 정보

이 연구와 관련된 용어

키워드

추가 관련 MeSH 약관

기타 연구 ID 번호

  • RC24_0471
  • 2025-A00724-45 (기타 식별자: ANSM)

개별 참가자 데이터(IPD) 계획

개별 참가자 데이터(IPD)를 공유할 계획입니까?

미정

IPD 계획 설명

Individual participant data may be shared upon reasonable request, subject to sponsor approval and compliance with French/EU data protection regulations (GDPR).

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아니

이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .

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