Skip to main content
SpringerLink
Log in

Vaginal misoprostol for cervical priming prior to diagnostic hysteroscopy––efficacy, safety and patient satisfaction: a randomized controlled trial

  • Original Article
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objective

To evaluate the effectiveness and safety of vaginal misoprostol for cervical priming prior to diagnostic hysteroscopy and to assess impact on pain scores and patient satisfaction.

Methods

One hundred women undergoing hysteroscopy were randomly allocated into two groups. The study group (n = 50) received 400 µg of misoprostol vaginally (self administered) 4–6 h prior to hysteroscopy while the control group (n = 50) did not receive any cervical priming. Primary outcome measured was need for cervical dilatation, analgesia or sedation. Secondary outcomes were pain scores, patient satisfaction and side effects.

Results

There was no significant difference in the need for cervical dilatation, analgesia or sedation in the two groups (P = 0.25, 0.64 and 0.5, respectively). In addition, there was no difference in subjective patient satisfaction (P = 0.70). However, those in the control group recorded a higher pain score (median ± SD = 5 ± 1.8) when compared to those who received misoprostol (median ± SD = 4.5 ± 2, P = 0.03). Only two women (4%) had bleeding per vaginum and one (2%) had a slight fever attributable to misoprostol.

Conclusion

Vaginal misoprostol prior to diagnostic hysteroscopy did not facilitate cervical dilatation. It did effect a reduction in pain scores, but there was no difference in patient satisfaction, need for analgesia or sedation. No significant side effects were reported.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Barcaite E, Bartusevicius A, Railaite DR, Nadisauskiene R (2005) Vaginal misoprostol for cervical priming before hysteroscopy in perimenopausal and postmenopausal women. Int J Gynecol Obstet 91:141–145

    Article  CAS  Google Scholar 

  2. Bisharah M, Al-fozan H, Tulandi T (2003) A randomized trial of sublingual misoprostol for cervical priming before hysteroscopy. J Am Assoc Gynecol Laparosc 10(3):390–391

    Article  PubMed  Google Scholar 

  3. Collins PW (1990) Misoprostol: discovery, development, and clinical applications. Med Rev Res 10:149–172

    Article  CAS  Google Scholar 

  4. Cooper KG, Pinion SB, Bhattacharya S, Parkin DE (1996) The effects of the gonadotrophin releasing hormone analogue (goserelin) and prostaglandin E1 (misoprostol) on cervical resistance before transcervical resection of the endometrium. Br J Obstet Gynaecol 103:375–378

    PubMed  CAS  Google Scholar 

  5. Fung TM, Lam MH, Wong SF, Ho LC (2002) A randomised placebo-controlled trial of vaginal misoprostol for cervical priming before hysteroscopy in postmenopausal women. Br J Obstet Gynaecol 109:561–565

    CAS  Google Scholar 

  6. Li YT, Chen TH, Kuo TC (2006) Cervical softening with vaginal misoprostol before hysterosalpingography. Eur J Obstet Gynecol Reprod Biol 134:130–131

    Article  PubMed  Google Scholar 

  7. Lokugamage AU, Refaey HE, Rodeck CH (2003) Misoprostol and pregnancy: ever-increasing indications of effective usage. Curr Opin Obstet Gynecol 15:513–518

    Article  PubMed  Google Scholar 

  8. Ngai SW, Tang OS, Lao T, Ho PC, Ma HK (1995) Oral misoprostol versus placebo for cervical dilatation before vacuum aspiration in first trimester of pregnancy. Hum Reprod 10:1220–1222

    PubMed  CAS  Google Scholar 

  9. Preen AE, Mc-Keeby JL, Catherino W, Alvero RJ (2002) Oral misoprostol prior to operative hysteroscopy does not enhance cervical dilation or improve operative time: a prospective randomized, double blind, placebo-controlled trial. Fertil Steril 78(3):S79–S80

    Article  Google Scholar 

  10. Preutthipan S, Herabutya Y (1999) A randomized controlled trial of vaginal misoprostol for cervical priming before hysteroscopy. Obstet Gynecol 94:427–430

    Article  PubMed  CAS  Google Scholar 

  11. Preutthipan S, Herabutya Y (2000) Vaginal misoprostol for cervical priming before operative hysteroscopy: a randomized controlled trial. Obstet Gynecol 96:890–894

    Article  PubMed  CAS  Google Scholar 

  12. Preutthipan S, Herabutya Y (2006) A randomized comparison of vaginal misoprostol and dinoprostone for cervical priming in nulliparous women before operative hysteroscopy. Fertil Steril 86:990–994

    Article  PubMed  Google Scholar 

  13. Singh K, Fong YF, Prasad RN, Dong F (1998) Randomized trial to determine optimal dose of vaginal misoprostol for preabortion cervical priming. Obstet Gynecol 92(5):795–798

    Article  PubMed  CAS  Google Scholar 

  14. Tang OS, Schweer H, Seyberth HW, Lee SW, Ho PC (2002) Pharmacokinetics of different routes of administration of misoprostol. Hum Reprod 17:332–336

    Article  PubMed  CAS  Google Scholar 

  15. Thomas JA, Leyland N, Durand N, Windrim RC (2002) The use of oral misoprostol as a cervical ripening agent in operative hysteroscopy: a double-blind, placebo-controlled trial. Am J Obstet Gynecol 186:876–879

    Article  PubMed  CAS  Google Scholar 

  16. Zieman M, Fong SK, Benowitz NL, Banskter D, Darney PD (1997) Absorption kinetics of misoprostol with oral or vaginal administration. Obstet Gynecol 90:88–92

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi, 110029, India

    Neeta Singh, Bhaswati Ghosh, Moumita Naha & Suneeta Mittal

Authors
  1. Neeta Singh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bhaswati Ghosh
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Moumita Naha
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Suneeta Mittal
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Bhaswati Ghosh.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Singh, N., Ghosh, B., Naha, M. et al. Vaginal misoprostol for cervical priming prior to diagnostic hysteroscopy––efficacy, safety and patient satisfaction: a randomized controlled trial. Arch Gynecol Obstet 279, 37–40 (2009). https://doi.org/10.1007/s00404-008-0666-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-008-0666-8

Keywords

Search

Navigation