Mifepristone does not induce cervical softening in non-pregnant women

Ben-Chetrit, Avraham; Eldar‐Geva, Talia; Lindenberg, Tzina; Farhat, Morshed; Shimonovitz, Shlomo; Zacut, D.; Gelber, Hadassa; Sitruk-Ware, Régine; Spitz, Irving M.

doi:10.1093/humrep/deh420

Cited by 20 publications

(23 citation statements)

References 22 publications

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“…Although the use of saline solution as distension medium has been preferred to carbon dioxide by some authors (8,9), other authors (10,11) observed similar discomfort with the use of one or the other. Misoprostol and mifepristone are effective in cervical ripening, but their use causes more severe pain and discomfort, without any advantage in terms of quality of visualization (12)(13)(14).…”

mentioning

confidence: 99%

Efficacy of intravenous tramadol treatment for reducing pain during office diagnostic hysteroscopy

Floris

Piras

Orrù

et al. 2007

Fertility and Sterility

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mentioning

confidence: 99%

Efficacy of intravenous tramadol treatment for reducing pain during office diagnostic hysteroscopy

Floris

Piras

Orrù

et al. 2007

Fertility and Sterility

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“…Six studies were considered eligible for inclusion in the review (Figure 1). 11–16 The inter‐rater reliability for the study selection was very good (κ = 0.86). Four of the six papers were deemed to be of high quality 12,13,15,16 (Figure 2).…”

Section: Resultsmentioning

confidence: 99%

“…An attempt was made to contact authors for their primary data but unfortunately insufficient data were received to be able to perform any analysis. The incidence of gastrointestinal adverse effects were reported by two studies, 15,16 bleeding by four studies, 11,14–16 cervical lacerations by three studies 11,13,16 and failed procedures by three studies 12,13,15 . These results were meta‐analysed.…”

Section: Resultsmentioning

confidence: 99%

“…[11][12][13][14][15][16] The inter-rater reliability for the study selection was very good (j = 0.86). Four of the six papers were deemed to be of high quality 12,13,15,16 (Figure 2). Details of the study Cervical preparation for outpatient hysteroscopy ª 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology ª 2011 RCOG populations and intervention are shown in Table 1.…”

Section: Study Selection Details and Qualitymentioning

confidence: 93%

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Does cervical preparation before outpatient hysteroscopy reduce women’s pain experience? A systematic review

Cooper

Smith

Khan³

et al. 2011

BJOG: An International Journal of Obstetrics &Amp; Gynaecology

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Background Studies examining the use of pharmaceutical (prostaglandins, antiprogestogens) and mechanical (osmotic dilators) dilatation of the cervix before hysteroscopy under general anaesthesia have produced conflicting results regarding their effect on cervical dilatation and trauma during the procedure.Objective To compare the effect on pain and need for cervical dilatation of various methods of cervical preparation before outpatient hysteroscopy.Search strategy MEDLINE, EMBASE and CINAHL were searched using a combination of the keywords 'hysteroscopy', 'vaginoscopy', 'cervical ripening', 'laminaria', 'progest*', 'prostaglandin', 'oestrogen' 'cervical preparation' and their associated Medical Subject Headings The Cochrane Library was searched using the keywords 'hysteroscopy' and 'cervical'. There were no limits or filters placed on the searches.Selection criteria Randomised controlled trials that examined women undergoing outpatient hysteroscopy, where the intervention was the use of cervical preparation versus a control or placebo and the outcome was pain assessment.Data collection and analysis Two reviewers independently selected trials. Data were extracted on pain, the effect on dilatation, adverse effects, trauma and feasibility. Data regarding pain and cervical dilatation were unsuitable for meta-analysis. Meta-analyses were performed for adverse effects and feasibility using the random effects models to calculate the Peto odds ratio.Results From 585 abstracts, six studies were selected for inclusion in the systematic review. The results suggest that there may be a benefit of using prostaglandins for postmenopausal women; however, there is no high-quality evidence that giving misoprostol before outpatient hysteroscopy reduces the pain experienced by women of reproductive age. There is some evidence that prostaglandins reduce the force and requirement for dilatation of the cervix beyond 5 mm.Author's conclusions There is no evidence to recommend the routine administration of mifepristone or misoprostol to women before outpatient hysteroscopy. Cervical priming with vaginal prostaglandins may be considered in postmenopausal women if using hysteroscopic systems >5 mm in diameter.

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“…Although misoprostol has been demonstrated to cause cervical ripening and dilation in the pregnant patient, 19 results with the same medication in similar doses and administration times in the nonpregnant patient are conflicting. 23,24 Few studies have investigated the use of cervical priming agents in office hysteroscopy alone. The first received 400 g of misoprostol vaginally 4 to 6 hours before the procedure, and the control group received nothing.…”

Section: Cervical Primingmentioning

confidence: 99%

Office Hysteroscopy

Finkenzeller

Altman

2010

Postgraduate Obstetrics & Gynecology

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Learning Objectives: After reading this issue, the obstetrician-gynecologist should be better able to: 1. Evaluate indications for hysteroscopy in the office setting. 2. Use techniques for office hysteroscopy, including patient preparation and pain control. 3. Demonstrate procedures feasible to perform with hysteroscopy in the office setting.Lippincott Continuing Medical Education Institute, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Lippincott Continuing Medical Education Institute, Inc., designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.To earn CME credit, you must read the CME article and complete the quiz and evaluation on the enclosed answer form, answering at least seven of the 10 quiz questions correctly.

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Mifepristone does not induce cervical softening in non-pregnant women

Abstract: Unlike its dramatic effect in the pregnant uterus, mifepristone administered 30 h prior to hysteroscopy was not effective in ripening the cervix of non-pregnant women.

Cited by 20 publications

References 22 publications

Efficacy of intravenous tramadol treatment for reducing pain during office diagnostic hysteroscopy

Efficacy of intravenous tramadol treatment for reducing pain during office diagnostic hysteroscopy

Does cervical preparation before outpatient hysteroscopy reduce women’s pain experience? A systematic review

Office Hysteroscopy

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