Comparison of vaginal misoprostol and dinoprostone for cervical ripening before diagnostic hysteroscopy in nulliparous women

In a prospective, randomized study, vaginally administered dinoprostone is more effective than misoprostol for cervical ripening before diagnostic hysteroscopy.

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Authors

Hasan Ali Inal, M.D., Zeynep Hafiza Ozturk Inal, M.D., Esra Tonguc, M.D., Turgut Var, M.D.

Volume 103, Issue 5, Pages 1326-1331

Abstract

Objective:

To compare the effectiveness of vaginal misoprostol and dinoprostone for cervical ripening before diagnostic hysteroscopy in nulliparous women.

Design:

Placebo-controlled, double blind, randomized trial.

Setting:

Teaching and research hospital.

Patient(s):

Ninety women of reproductive age eligible for diagnostic hysteroscopy.

Intervention(s):

Randomly assignment to receive 400 μg of misoprostol (n = 30) or 10 mg of dinoprostone (n = 30) vaginally before diagnostic hysteroscopy, with a control group (n = 30) not receiving any cervical priming agent.

Main Outcome Measure(s):

Primary outcome: the number of women requiring cervical dilatation; secondary outcomes: cervical width before surgery, duration of dilatation time, ease of dilatation, complications during surgical procedure, and side effects of the drugs.

Result(s):

In the placebo group, 23 patients required cervical dilatation compared with 17 in the misoprostol group and 9 in the dinoprostone group. The mean (± standard deviation) cervical widths for the placebo, misoprostol, and dinoprostone groups were 4.23 ± 0.43 mm, 5.43 ± 0.5 mm, and 5.83 ± 0.64 mm, respectively. These widths were statistically significantly different. The duration of dilatation was also statistically significantly longer in the control group.

Conclusion(s):

Vaginally administered dinoprostone before diagnostic hysteroscopy is more effective than misoprostol for inducing cervical priming. Further studies are required to elucidate the most efficient option with the least side effects for cervical ripening.

Clinical Trial Registration Number:

NCT01620814.

Read the full text at: http://www.fertstert.org/article/S0015-0282(15)00084-9/fulltext


Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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