Different Routes of Misoprostol for Same-Day Cervical Priming Prior to Operative Hysteroscopy: A Randomized Blinded Trial

作者：Herman Hadas Ganer^*; Kerner Ram; Gluck Ohad; Feit Hagit; Keidar Ran; Bar Jacob; Sagiv Ron

来源：Journal of Minimally Invasive Gynecology, 2017, 24(3): 455-460.

DOI：10.1016/j.jmig.2016.12.024

• Cervical priming
• Misoprostol
• Operative hysteroscopy

Study Objective: To compare the effectiveness of and patient satisfaction with different routes of misoprostol administration for short-term cervical priming before operative hysteroscopy.
Design: Randomized blinded trial (Canadian Task Force classification I).
Setting: University hospital.
Patients: One hundred and twenty patients undergoing operative hysteroscopy.
Interventions: Patients were randomly assigned to receive 400 mu g of misoprostol administered orally (n = 40), vaginally (n = 40), or sublingually (n = 40) for cervical priming at 1.5 to 4 hours before undergoing operative hysteroscopy.
Measurements and Main Results: The primary outcome was preoperative cervical dilatation. Secondary outcomes included cervical consistency, ease of dilation and time of dilation, patient discomfort, and side effects. No differences were noted among the 3 groups in terms of patient age, parity, previous vaginal delivery, menopausal status, and time interval from preparation to procedure. Patients in the 3 groups reported similar discomfort and side effects. Initial mean cervical dilatation was 6.1 +/- 2.0 mm in the oral group, 6.4 +/- 2.1 in the vaginal group, and 6.4 +/- 1.8 mm in the sublingual group (p = .75). Cervical consistency and ease of dilation were similar among the groups. The mean time of dilation was 37.2 +/- 30.6 seconds in the oral group, 31.7 +/- 29.0 seconds in the vaginal group, and 31.5 +/- 21.7 seconds in the sublingual group (p = .59). Additional sub analyses according to menopausal status and parity did not demonstrate any differences among the groups.
Conclusion: Same-day cervical priming for operative hysteroscopy is achieved equally with all routes of misoprostol administration, with similar patient satisfaction and side effects.

• 出版日期2017-4