A double-blind randomized controlled trial of vaginal misoprostol for cervical priming before outpatient hysteroscopy
Akmal El-Mazny, Nermeen Abou-Salem, Akmal El-Mazny, Nermeen Abou-Salem
Abstract
Objective: To evaluate the efficacy and safety of vaginal misoprostol for cervical priming before diagnostic outpatient hysteroscopy (OH) without anesthesia.
Design: Double-blind randomized controlled trial.
Setting: University teaching hospital.
Patient(s): One hundred fifty 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 = 75). In group I, 200 μg misoprostol was inserted into the posterior vaginal fornix 3 hours before OH; in group II (control), vaginal examination was performed without misoprostol administration. 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 μg vaginal misoprostol administered 3 hours before diagnostic OH is a simple, effective, and safe method of cervical priming to facilitate the procedure without anesthesia.
Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Source: PubMed