Publication: Misoprostol to prime the cervix before hysteroscopy
Issued Date
2000-05-25
Resource Type
ISSN
09539182
Other identifier(s)
2-s2.0-0034102127
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Mahidol University
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SCOPUS
Bibliographic Citation
Contemporary Reviews in Obstetrics and Gynaecology. Vol.12, No.1 (2000), 47-52
Suggested Citation
S. Preutthipan, Y. Herabutya Misoprostol to prime the cervix before hysteroscopy. Contemporary Reviews in Obstetrics and Gynaecology. Vol.12, No.1 (2000), 47-52. Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/26240
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Title
Misoprostol to prime the cervix before hysteroscopy
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Abstract
One of the major problems of hysteroscopy, especially operative hysteroscopy, is the difficulty encountered by the outer sheath of the instrument in entering the internal cervical os because of the discrepancy of diameter between the os and the outer sheath. Hence, the most common complications encountered during hysteroscopy are related to the difficulty of cervical dilatation; these include cervical tear, creation of false track and uterine perforation. Several methods have been employed for cervical priming in the past. Some authors prefer to avoid cervical trauma by inserting Laminaria into the cervical canal the night before surgery; others have used prostaglandins for this purpose. However, many of the prostaglandins used as cervical priming agents are expensive and not readily available, thus making them an unrealistic option for many regions. A third option for cervical priming is the use of misoprostol, a prostaglandin estriol analog marketed for the treatment of peptic ulcers. While misoprostol was designed for different purposes, it is also the ideal prostaglandin preparation for cervical ripening in labor induction, termination of pregnancy in the first trimester and missed abortion. Misoprostol is cheap, easy to store and widely available. We designed a prospective, double blind, randomized, placebo-controlled study to evaluate the effectiveness of vaginal misoprostol in facilitating cervical dilatation in non-pregnant women prior to hysteroscopy, and to determine its side-effects. Our study has shown that vaginal misoprostol as a cervical priming agent in non-pregnant women appears to be safe, effective, and easily affordable, with minimal side-effects. Pretreatment of non-pregnant patients needing hysteroscopy should be considered normal clinical practice.