Comparison between 200 μg and 800 μg of vaginal misoprostol for cervical ripening prior to operative hysteroscopy: A randomized controlled trial.

Abstract

OBJECTIVE\nTo compare between 200 μg and 800 μg of vaginal misoprostol for cervical ripening prior to operative hysteroscopy.\n\n\nMETHODS\nQuadruble-blind randomized clinical trial conducted between November 2019 and September 2020 involving 76 patients undergoing cervical dilatation prior to surgical hysteroscopy at teaching hospitals in Pernambuco, Brazil. Women received the vaginal misoprostol dosage of 200 μg or 800 μg,10-12 hours before operative hysteroscopy. The cervical width was the primary outcome, and the secondaries were patient s satisfaction, side effects, surgical complications and duration of cervical dilatation. Chi-square tests of association, Fisher s exact and Mann-Whitney tests were used with an alpha error of less than 5%.\n\n\nRESULTS\nThere was no statistical difference between the groups in the mean of the cervical width (800 μg: 6.5 ± 1.6mm versus 200 μg: 5.8 ± 1.8mm, p=0.055), patient s satisfaction and surgical findings except for the duration of cervical dilatation, that was lower in the 800 μg group (28.16 ± 28.5s versus 41.97 ± 31.0s, p=0.035). Among the side effects, diarrhea was more frequent in 800 μg group with statistical difference (100% versus 0%; p=0.01).\n\n\nCONCLUSION\nFor cervical ripening, 200 μg misoprostol is equally effective with less adverse effects than 800 μg before operative hysteroscopy.