Publication: Vaginal misoprostol for cervical priming before operative hysteroscopy: A randomized controlled trial
Issued Date
2000-11-27
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ISSN
00297844
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2-s2.0-0033731731
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Mahidol University
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SCOPUS
Bibliographic Citation
Obstetrics and Gynecology. Vol.96, No.6 (2000), 890-894
Suggested Citation
Sangchai Preutthipan, Yongyoth Herabutya Vaginal misoprostol for cervical priming before operative hysteroscopy: A randomized controlled trial. Obstetrics and Gynecology. Vol.96, No.6 (2000), 890-894. doi:10.1016/S0029-7844(00)01063-2 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/26110
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Title
Vaginal misoprostol for cervical priming before operative hysteroscopy: A randomized controlled trial
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Abstract
Objective: To investigate the effectiveness of vaginal misoprostol for cervical priming before operative hysteroscopy and to assess the cervicouterine complications related to cervical dilatation and hysteroscopic surgery in nulliparous women. Methods: One hundred fifty-two women with definite intrauterine lesions were randomly assigned to receive either 200 μg vaginal misoprostol or placebo. Cervical response and outcome and complications of operative hysteroscopy were assessed. Results: Thirty-five subjects were needed in each arm to detect a type I error of 0.01 with a power of 0.99. The mean cervical dilatation estimated by Hegar dilator was significantly different between the treated group (7.3 ± 0.7 mm) and the control group (3.8 ± 1.1 mm, P < .001). In the misoprostol group, 55 (75.3%) patients needed cervical dilation, compared with 75 (94.9%, P = .001) in the placebo group. The median time of cervical dilation to Hegar number 9 was significantly shorter in the treated group (40 seconds) compared with the control group (120 seconds, P < .001). The mean operative time was significantly shorter in the treated group (36.4 ± 10.9 minutes) compared with the control group (45.9 ± 14.2 minutes, P < .001). Cervical tears occurred in nine (11.4%) patients in the control group and in one (1.4%, P = .018) in the misoprostol group. Creation of a false tract was more common in the control group. Two uterine perforations occurred in the placebo group. Conclusion: Vaginal misoprostol applied before operative hysteroscopy reduced the need for cervical dilation, facilitated hysteroscopic surgery, and minimized cervical complications. (C) 2000 by The American College of Obstetricians and Gynecologists.