Clinical Trial: Pelvic Examination in Pregnancy

Study Status: Completed
Recruit Status: Completed
Study Type: Interventional

Official Title: Utility of Pelvic Examination in the Evaluation of Threatened Abortion

Brief Summary: This study is designed to determine whether the pelvic examination (including bimanual and speculum examination) is necessary in patients with first trimester vaginal bleeding/ lower abdominal pain when an intra-uterine pregnancy (IUP) is seen on ultrasound. Patients with the chief complaint of vaginal bleeding or lower abdominal pain less than 16 weeks and positive HCG will be considered for this non-inferiority-designed clinical trial. All patients who present to the BMC Emergency Department (ED) Mon - Fri from 8am to 11pm and have had serum or urine HCG testing and a formal ultrasound by a credentialed emergency physician or radiology technician as part of standard of care will be screened for further eligibility. Those patients with intra-uterine pregnancies < 16 weeks gestation seen on ultrasound and meet inclusion criteria will then be asked to provide informed consent to participate in the study. Randomization will occur after consent has been obtained. Half of the patients will be randomized to receive pelvic examinations and the other half will not. Further care will be determined by the treating attending physician. The primary outcome will be a composite morbidity endpoint at 30 days, including return visits to the ED, emergency surgery, need for transfusion, infection, or other missed source of bleeding/ pain. Secondary outcomes of interest include ED throughput time, and patient satisfaction.

Detailed Summary:
Sponsor: Boston Medical Center

Current Primary Outcome: Composite Morbidity Endpoint [ Time Frame: 30 Days ]

Adverse events include, but are not limited to, return visits to the Emergency Department, need for hospital admission, emergency procedure, transfusion, infection, or identification of other source of symptoms.


Original Primary Outcome: Same as current

Current Secondary Outcome:

  • Patient Satisfaction [ Time Frame: 24 Hours ]
  • Throughput Time [ Time Frame: 24 Hours ]


Original Secondary Outcome: Same as current

Information By: Boston Medical Center

Dates:
Date Received: February 27, 2012
Date Started: February 2012
Date Completion:
Last Updated: May 3, 2017
Last Verified: May 2017