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Vaginal Misoprostol for Cervical Priming Before Outpatient Hysteroscopy: A Randomized Controlled Trial

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Last updated: 03 Jan 2025

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Abstract

Background: Misoprostol has generally shown good efficacy in promoting cervical softness and facilitating hysteroscopic procedures.
Objective: To evaluate the efficacy and safety of vaginal misoprostol for cervical priming before diagnostic outpatient hysteroscopy (OH) without anesthesia.
Patients and Methods: Design: Double-blind randomized controlled trial. Setting: University teaching hospital. Patient(s): Ninety patients requiring diagnostic OH for investigation of infertility or abnormal uterine bleeding in the reproductive age. Intervention(s): Patients were randomly allocated into two equal groups (n= 45). In group I, 200 mcg misoprostol was inserted into the posterior vaginal fornix 3 hours before OH; in group II (control), 250 mg metronidazole as placebo was inserted into the posterior vaginal fornix by investigator. A rigid 30 4-mm hysteroscope was used in the vaginoscopic technique. Main Outcome Measure(s): Ease of cervical entry (Likert scale), procedural time, patient acceptability (Likert scale), and pain scoring (visual analog scale).
Result(s): Vaginal misoprostol significantly facilitated the procedure; cervical entry was easier, procedural time was shorter, patient acceptability was higher, and pain scoring was lower in group I compared with group II. Side effects of misoprostol were infrequent, minor, and transient. No complications were reported. Conclusion(s): The regimen of 200 mcg vaginal misoprostol administered 3 hours before diagnostic OH is a simple, effective, and safe method of cervical priming to facilitate the procedure without anesthesia.

DOI

10.21608/ejhm.2018.9785

Keywords

misoprostol, cervical priming, outpatient hysteroscopy

Authors

First Name

Anis Mansour Nagib

Last Name

Younis

MiddleName

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Affiliation

Department of Obstetrics and Gynecology, Faculty of Medicine, Ain shams University, Cairo, Egypt

Email

niso0200@gmail.com

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Orcid

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First Name

Mohamed Ibrahim

Last Name

Amer

MiddleName

-

Affiliation

Department of Obstetrics and Gynecology, Faculty of Medicine, Ain shams University, Cairo, Egypt

Email

-

City

-

Orcid

-

First Name

Malames

Last Name

Faisal

MiddleName

-

Affiliation

Department of Obstetrics and Gynecology, Faculty of Medicine, Ain shams University, Cairo, Egypt

Email

-

City

-

Orcid

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Volume

72

Article Issue

6

Related Issue

1884

Issue Date

2018-07-01

Receive Date

2018-07-28

Publish Date

2018-07-01

Page Start

4,586

Page End

4,592

Print ISSN

1687-2002

Online ISSN

2090-7125

Article File

EJHM_Volume 72_Issue 6_Pages 4586-4592.pdf

PDF . 338.1kB

Link

https://ejhm.journals.ekb.eg/article_9785.html

Detail API

https://ejhm.journals.ekb.eg/service?article_code=9785

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Original Article

Type Code

606

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

Vaginal Misoprostol for Cervical Priming Before Outpatient Hysteroscopy: A Randomized Controlled Trial

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Article

Created At

22 Jan 2023