Cost-utility Analysis of Outpatient Manual Vacuum Aspiration Versus Operating Room Electric Aspiration for the Management of First-trimester Miscarriage (ASPIR)
Cost-utility Analysis of Outpatient Manual Vacuum Aspiration Versus Operating Room Electric Aspiration for the Management of First-trimester Miscarriage (ASPIR Study)
Обзор исследования
Статус
Вмешательство/лечение
Подробное описание
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.
Тип исследования
Регистрация (Оцененный)
Фаза
- Непригодный
Контакты и местонахождение
Контакты исследования
- Имя: Thibault Thubert, Pr
- Номер телефона: +33253482443
- Электронная почта: thibault.thubert@chu-nantes.fr
Места учебы
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Nantes, Франция, 44000
- CHU de Nantes
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Контакт:
- Thibault Thubert, Pr
- Номер телефона: +33 2 53 48 24 43
- Электронная почта: thibault.thubert@chu-nantes.fr
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Критерии участия
Критерии приемлемости
Возраст, подходящий для обучения
- Взрослый
Принимает здоровых добровольцев
Описание
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
Учебный план
Как устроено исследование?
Детали дизайна
- Основная цель: Исследования в области здравоохранения
- Распределение: Рандомизированный
- Интервенционная модель: Параллельное назначение
- Маскировка: Нет (открытая этикетка)
Оружие и интервенции
Группа участников / Армия |
Вмешательство/лечение |
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Экспериментальный: Manual vacuum aspiration (MVA)
Outpatient manual vacuum aspiration under local anesthesia and inhaled analgesia (MEOPA).
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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.
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Активный компаратор: 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.
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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.
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Что измеряет исследование?
Первичные показатели результатов
Мера результата |
Мера Описание |
Временное ограничение |
|---|---|---|
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Incremental cost-utility ratio (ICUR)
Временное ограничение: 3 months
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Incremental cost per quality-adjusted life year (QALY) gained of outpatient MVA compared to operating room EA, from a collective perspective.
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3 months
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Вторичные показатели результатов
Мера результата |
Мера Описание |
Временное ограничение |
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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
Временное ограничение: up to 5 years
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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
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up to 5 years
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To compare the two management strategies in terms of success and intraoperative and postoperative complications
Временное ограничение: 1 month
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To compare the two management strategies in terms of success and intraoperative and postoperative complications
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1 month
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To assess patient satisfaction
Временное ограничение: day 1 and 2
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To assess patient satisfaction: A numerical scale (NS) (0-10) on Days 1 and 2. |
day 1 and 2
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To compare the two strategies (electric suction versus manual vacuum kit suction)
Временное ограничение: days 0, 1,7 and 1 and 3 months
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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
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The risk factors for failure
Временное ограничение: 3 months
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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).
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3 months
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Satisfaction with the patient's care by medical staff
Временное ограничение: day 0 and 1 month
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Satisfaction with the patient's care by medical staff will be assessed using an EN (numerical scale 0 to 10) at D0 and M1
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day 0 and 1 month
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Patient having been pregnant in days
Временное ограничение: 12 months
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Patient having been pregnant at 12 months, pregnancy outcome and time to conception in days.
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12 months
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To assess patient satisfaction
Временное ограничение: day 1 and 2 and 1 month et 3 month
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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
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To assess patient satisfaction
Временное ограничение: 1 and 3 months
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HADS (Hospital Anxiety and Depression Scale) and PCL-5 questionnaires at 1 and 3 months
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1 and 3 months
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To compare the two strategies (electric suction versus manual vacuum kit suction)
Временное ограничение: Day 0, 1,7 and 1 and 3 months
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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
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To compare the two strategies (electric suction versus manual vacuum kit suction)
Временное ограничение: Day 0 to 7
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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
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To compare the two strategies (electric suction versus manual vacuum kit suction)
Временное ограничение: Day 0 to 7
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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
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To compare the two strategies (electric suction versus manual vacuum kit suction)
Временное ограничение: Day 0
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To compare the two strategies (electric suction versus manual vacuum kit suction), measurement of:
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Day 0
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To compare the two strategies (electric suction versus manual vacuum kit suction)
Временное ограничение: 1 and 3 months
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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
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To compare the two strategies (electric suction versus manual vacuum kit suction)
Временное ограничение: 1 et 3 months
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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
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Соавторы и исследователи
Спонсор
Следователи
- Главный следователь: Thibault Thubert, Pr, Nantes university hospital
Даты записи исследования
Изучение основных дат
Начало исследования (Оцененный)
Первичное завершение (Оцененный)
Завершение исследования (Оцененный)
Даты регистрации исследования
Первый отправленный
Впервые представлено, что соответствует критериям контроля качества
Первый опубликованный (Действительный)
Обновления учебных записей
Последнее опубликованное обновление (Действительный)
Последнее отправленное обновление, отвечающее критериям контроля качества
Последняя проверка
Дополнительная информация
Термины, связанные с этим исследованием
Ключевые слова
Дополнительные соответствующие термины MeSH
Другие идентификационные номера исследования
- RC24_0471
- 2025-A00724-45 (Другой идентификатор: ANSM)
Планирование данных отдельных участников (IPD)
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Описание плана IPD
Информация о лекарствах и устройствах, исследовательские документы
Изучает лекарственный продукт, регулируемый FDA США.
Изучает продукт устройства, регулируемый Управлением по санитарному надзору за качеством пищевых продуктов и медикаментов США.
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