Sublingual Misoprostol for cervical ripening before diagnostic hysteroscopy: A Randomized and prospective study about 108 cases

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Published Dec 9, 2011
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Vol. 89 No. 11 (2011): Issue Nov 2011

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Nabil Mathlouthi
Ola Saodi
Riadh Ben Temime
Service de gynécologie hôpital Charles Nicolle Tunis
Tahar Makhlouf
Leila Attia
Abdellatif Chachia

Abstract

Aim: To evaluate the benefits of cervical preparation with 200 mcg of Misoprostol administered 2 hours before diagnostic hysteroscopy.
Methods: Prospective randomized and double-blind study. A total of 108 patients were randomized into two groups: The first group G1 of 54 patients who received 200 mcg Misoprostol sublingually, two hours before diagnostic hysteroscopy, and a control group of 54 G2 patients without prior preparation. The surgeons were not informed before each act to which group the patient belongs. The parameters analyzed were: the rate of patients requiring dilation to Hegar candle to introduce the hysteroscope, hysteroscopy complications, and the side effects of Misoprostol.
Results: In the Misoprostol group, 5 patients required the use of mechanical cervical dilatation (9.2%) against 12 patients (22.2%) in the control group. The average diameter of the larger candle used was 5.3 mm in the Misoprostol group against 4.2 mm in the control group. No significant difference was found between the two groups concerning the rate of complications in both procedures. By comparing the effect of Misoprostol in the group of postmenopausal women, no significant differences were observed regarding the use of cervical dilation or the rate of complications during hysteroscopy. Mor-over, no significant difference was observed in patients with a history of vaginal delivery.
Conclusion: No significant difference was noted in this study between Misoprostol group and control group, despite less use of cervical dilation and less complications in Misoprostol group.

Keywords:

Hyteroscopy, Misoprostol, Cervical ripening

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