The effect of adding hyoscine to vaginal misoprostol on shortening the time of abortion induction

Abstract

Induced abortion is the termination of pregnancy by medical or surgical methods before the fetus' viability. Available evidences show that due to spasmolytic effects, use of Hyoscine with Misoprostol may reduce the pain during abortion induction. The aim of this study is to evaluate the effect of Misoprostol in combination with Hyoscine compared with Misoprostol alone in reducing the duration of abortion induction. In a clinical trial at the Department of Obstetrics and Gynecology, Qazvin University of Medical Sciences on 126 pregnant women with gestational age below 20 weeks elected for abortion, the effect of Misoprostol in combination with Hyoscine compared with Misoprostol alone was evaluated in reducing the duration of abortion induction. The mean duration of abortion induction in Misoprostol with Hyoscine represented statistically significant decrease compared with Misoprostol (653.38 ± 80.386 min, with 726.29 ± 64.56 min) (P ≤ 0.001). There was no significant difference in demographic characteristics, including maternal age, gestational age, gravidity, parity and history of abortion between the two study groups, and the two groups were homogeneous. Duration of abortion induction (p < 0.001), the rate of vaginal bleeding (p < 0.001), and the rate of hemoglobin deficiency (p = 0.002) in the group receiving Misoprostol suppositories and Hyoscine was significantly lower than in the group receiving Misoprostol suppositories alone. The need for analgesics in the group receiving Misoprostol suppositories and Hyoscine was significantly less than in the group receiving Misoprostol suppositories alone (p < 0.001). Finally, results of this study showed that adding 20 mg Hyoscine intra venous to vaginal Misoprostol is effective in significantly reducing the duration of the abortion induction, getting less pain killers, less vaginal bleeding and less decrease in hemoglobin changes.

Cervical ripening with vaginal Misoprostol plus Hyoscine-N-Butylbromide versus vaginal Misoprostol alone among pregnant women: a double-blind randomised controlled trial

“…It overcomes cervical spasm by its selective blocking action on the intramural parasympathetic ganglia of the cervico-uterine plexus, thus aids cervical dilatation without affecting uterine contractions. 9,17,20 This mechanism of action of hyoscine explains its effectiveness on cervical ripening as obtained in this study, duration of first stage of labour 9 , abortion process 19 , and intrauterine procedures. 21 The clinical significance of the shorter cervical ripening time obtained in this study with combined vaginal misoprostol and intramuscular hyoscine, is that this combination may be more suitable for clinical conditions where there is need to ripen the cervix faster and expedite delivery before induction of labour.…”

“…This finding is in agreement with the report of Naeiji et al 17, who conducted a randomized control trial to compare the effect of the use of Hyoscine to placebo on cervical ripening and found a statistically significant higher Bishop score in the Hyoscine group. Similarly, Tehranian et al 18 and Ezzatalsadat et al 19 reported statistically significant increases in the success rate of abortion and shortened duration of abortion induction, respectively, with combined intravenous Hyoscine and vaginal Misoprostol for abortion. Although their studies were in women with previable pregnancies, likely, the effect of hyoscine on both the abortion process and cervical changes during labour at term follow the same mechanism.…”

Effect of Combined Intramuscular Hyoscine and Vaginal Misoprostol on the Mean Induction to Delivery Interval among Post-date Pregnant Women in Federal Medical Center Owerri, Nigeria

“…Several studies have found that misoprostol is effective as an agent for cervical ripening and induction of labour. It is inexpensive, easy to store, and stable at room temperature [10]. Misoprostol however can be challenging to use because most preparations in the market come in tablets of 200mcg.…”

Investigation of the antibiotic residues of broiler meat in northern Iran

“…10 Although some food processing methods and different techniques may partially help to reduce the residual level of these antibiotics in food. 11 Examining antibiotic residues in chicken meat samples has been done by many researchers around the world. For example, in the research conducted to determine the enrofloxacin residue in chicken muscles collected from broiler chicken farms around Tehran, 24% of the broiler chicken farms had more than allowed antibiotic residue.…”

“…Consumption of food contaminated with tetracycline residues, especially at chronic levels, has harmful effects on both humans and animals 10 . Although some food processing methods and different techniques may partially help to reduce the residual level of these antibiotics in food 11 …”