Sublingual versus vaginal misoprostol for cervical ripening before hysteroscopy: a randomized clinical trial

Tanha, Fatemeh Davari; Salimi, Shohreh; Ghajarzadeh, Mahsa

doi:10.1007/s00404-012-2652-4

Cited by 14 publications

(12 citation statements)

References 14 publications

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“…We tried in this study to find if there were any positive or negative consequences of using different dosages of oral misoprostol. Hence, 200 and 400 µg sublingual misoprostol had been shown to be effective for cervical priming in pregnant women [13] and before surgical hysteroscopy in peri-menopausal women [14]. Four hundred micrograms of oral or vaginal misoprostol is found useful for cervical dilatation up to 10 mm prior to operative hysteroscopy [15].…”

Section: Discussionmentioning

confidence: 99%

Use of Oral Misoprostol for Cervical Priming before Hysteroscopy: A Randomized Comparison of Two Dosages

Kesrouani¹,

Maalouf²,

Mansour³

et al. 2015

Gynecol Obstet Invest

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Objective: The study aims to compare the safety and effectiveness of 200 and 400 µg of oral misoprostol for cervical priming before hysteroscopy. Methods: A double-blinded randomized study included 70 patients scheduled for hysteroscopy in a Lebanese University Hospital. Two dosages of oral misoprostol (200 or 400 µg) were randomly distributed to these patients 1 h before surgery under general anesthesia. Subjective assessment of the ease of dilatation, size of the first used Hegar, cervical injuries, bleeding or uterine perforation, duration of the procedure and misoprostol adverse effect were all noted and compared. Results: The difficulty of dilation until a Hegar 10 was similar for both treatment groups. Operative time was not reduced with a higher misoprostol dosage. We found 2 uterine perforations within the 200 µg group (6.7%), and none within the 400 µg group. Cervical lacerations and bleeding were similar (20%) for both treatment groups. A 2-fold increase in side effects (nausea, vomiting and cramps) is reported among the 400 µg group. Conclusions: Increasing the dose of misoprostol from 200 to 400 mg doubled the rate of side effects while no clinical benefit was noted. Larger trials are needed to assess rates of uterine perforation with the 200 µg dosage.

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Section: Discussionmentioning

confidence: 99%

Use of Oral Misoprostol for Cervical Priming before Hysteroscopy: A Randomized Comparison of Two Dosages

Kesrouani¹,

Maalouf²,

Mansour³

et al. 2015

Gynecol Obstet Invest

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“…24 In addition, there exists high-quality evidence that cervical ripening with sublingual administration of 400 mg misoprostol is more effective in postmenopausal women compared with alternative routes of administration. 25,26 There are emerging data regarding the use of vaginal prostaglandin E 2 (dinoprostone) in reproductive aged women before hysteroscopic procedures. In a double blinded randomized controlled trial of a total 49 patients, 10 mg of vaginal dinoprostone was reported to be a more effective cervical priming agent than both placebo and 400 mg vaginal misoprostol.…”

Section: Risk Reduction Recognition and Management Of Access-relatementioning

confidence: 99%

Complications of Hysteroscopic and Uterine Resectoscopic Surgery

Munro

Christianson

2015

Clinical Obstetrics &Amp; Gynecology

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Adverse events associated with hysteroscopic procedures are generally rare, but, with increasing operative complexity, it is now apparent that they are experienced more often. There exists a spectrum of complications that relate to generic components of procedures, such as patient positioning, anesthesia, and analgesia, to a number that are specific to intraluminal endoscopic surgery that largely comprise perforation and injuries to surrounding structures and blood vessels. Whereas a number of endoscopic procedures require the use of distending media, the response of premenopausal women to excessive absorption of nonionic fluids used for hysteroscopy is somewhat unique, and deserves special attention on the part the surgeon. There is also an increasing awareness of uncommon but problematic sequelae related to the use of monopolar radiofrequency uterine resectoscopes that involve thermal injury to the vulva and vagina. Furthermore, the uterus that has previously undergone hysteroscopic surgery may behave in unusual ways, at least in premenopausal women who experience menstruation or who become pregnant. Fortunately, better understanding of the mechanisms involved in these adverse events, as well as the use or development of a number of innovative devices, have collectively provided the opportunity to perform hysteroscopic and resectoscopic surgery in a manner that minimizes risk to the patient.

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“…Misoprostol (prostaglandin E1 analog) is used widely for cervical ripening, labor induction, postpartum hemorrhage and second trimester terminations [11,12]. It could increase myometrial contraction and decrease hemorrhage [10].…”

Section: Introductionmentioning

confidence: 99%

A single dose of misoprostol for reducing hemorrhage during myomectomy: a randomized clinical trial

Niroomand

Hajiha

Tabrizi

et al. 2015

Arch Gynecol Obstet

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Sublingual versus vaginal misoprostol for cervical ripening before hysteroscopy: a randomized clinical trial

Abstract: Sublingual route of misoprostol could be considered as an effective medication before surgical hysteroscopy in perimenopausal women.

Cited by 14 publications

References 14 publications

Use of Oral Misoprostol for Cervical Priming before Hysteroscopy: A Randomized Comparison of Two Dosages

Use of Oral Misoprostol for Cervical Priming before Hysteroscopy: A Randomized Comparison of Two Dosages

Complications of Hysteroscopic and Uterine Resectoscopic Surgery

A single dose of misoprostol for reducing hemorrhage during myomectomy: a randomized clinical trial

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