Efficacy and safety of oral vs vaginal misoprostol for cervical priming before hysteroscopy: A systematic review and meta-analysis

Abdelhakim, Ahmed Mohamed; Gadallah, Al-Hussein; Abbas, Ahmed M.

doi:10.1016/j.ejogrb.2019.10.023

Cited by 11 publications

(6 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The findings of the present study on the better efficacy of EPO compared to misoprostol are important because misoprostol is currently widely used for cervical dilation in gynecological procedures. However, as mentioned earlier, misoprostol has unpleasant adverse effects 2,9,20–22 . Consequently, EPO, which is a vegetable oil, has fewer side effects, lower price, and easier availability 11,15–18,23,24 …”

Section: Discussionmentioning

confidence: 96%

“…However, as mentioned earlier, misoprostol has unpleasant adverse effects. 2,9,[20][21][22] Consequently, EPO, which is a vegetable oil, has fewer side effects, lower price, and easier availability. 11,[15][16][17][18]23,24 Carreon and Gladys 24 compared the effect of oral EPO with vaginal dinoprostone in cervical preparation in hysteroscopic candidates.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of Misoprostol and Evening Primrose Oil on Cervical Preparation Before Gynecological Surgery

Rahbar

Sharafshahi

Ghods

et al. 2023

The Journal of Clinical Pharma

View full text Add to dashboard Cite

This study aimed to evaluate the efficacy and safety of evening primrose oil (EPO) for cervical ripening before gynecologic procedures and compare it to misoprostol. In this study, 40 hysteroscopy and dilation and curettage candidates were enrolled. Patients were randomly assigned to receive either 2000 mg of vaginal EPO (n = 20) or 200 μg of vaginal misoprostol (n = 20) 2 hours before the expected procedure. The measured outcomes were the size of the Hegar dilator that passed through the cervix effortlessly, uterine cervicovaginal complications, and drug-related side effects. The two groups were not significantly different in age, number of gravity, parity, type of delivery, and menopausal status (P > .05). The mean ± SD size of the first dilator was 5.25 ± 1.55 in the misoprostol group and 7.30 ± 1.08 in the EPO group (P < .001). The pain complaint in the EPO group was significantly lower (P = .027), but the two groups were not significantly different in terms of other complications. No cases of uterine or cervical rupture were seen in either group. The present study showed that 2000 mg of vaginal EPO was significantly more effective for cervical ripening than 200 μg of vaginal misoprostol before gynecological surgery. Therefore, it is recommended to use EPO as an alternative to misoprostol.

show abstract

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Comparison of Misoprostol and Evening Primrose Oil on Cervical Preparation Before Gynecological Surgery

Rahbar

Sharafshahi

Ghods

et al. 2023

The Journal of Clinical Pharma

View full text Add to dashboard Cite

show abstract

“…However, significantly more side effects such as bleeding, abdominal pain, and gastrointestinal symptoms occur under this [ 24 ]. Oral and vaginal administration of misoprostol appear equivalent, but side effects such as diarrhea are less common with vaginal administration [ 25 ]. However, data on patient satisfaction and complications are lacking.…”

Section: Discussionmentioning

confidence: 99%

Opinion paper: gynecological surgery in local anesthesia?

Neis

Wallwiener

Henes

et al. 2022

Arch Gynecol Obstet

View full text Add to dashboard Cite

Purpuse The paracervical block (PCB) is a local anesthesia procedure that can be used to perform gynecological surgeries without the need for further anesthesia. With the PCB, surgeries can be moved from the central operating room to outpatient operating rooms, where they can be performed without the presence of an anesthesia team. Methods In this paper, the indications, implementation and limitations of the procedure are discussed. Conclusion Especially in times of scarce staff and OR resources during the Corona pandemic, OR capacity can be expanded in this way.

show abstract

“…We also preferred the vaginal route for misoprostol administration as it is associated with faster cervical priming and dilatation with fewer side effects 51 . We used a small dose of misoprostol (200 μg) for better tolerability and safety as the side effects are dose‐dependent 45,50 .…”

Section: Discussionmentioning

confidence: 99%

Comparative efficacy of lidocaine–prilocaine cream and vaginal misoprostol in reducing pain during levonorgestrel intrauterine device insertion in women delivered only by cesarean delivery: A randomized controlled trial

Hashem

Mahmoud

Islam

et al. 2022

Intl J Gynecology & Obste

View full text Add to dashboard Cite

ObjectiveTo compare efficacy of lidocaine–prilocaine (LP) cream versus misoprostol versus placebo before levonorgestrel‐releasing intrauterine device (LNG‐IUD) insertion.MethodsThis randomized controlled trial (RCT) was conducted in a tertiary referral hospital from April 30, 2020 to March 1, 2021 on 210 parous women willing to receive LNG‐IUD and delivered only by elective cesarean delivery (CD). Participants received 200 μg vaginal misoprostol or 5 ml of LP cream 5% or placebo 3 h before LNG‐IUS insertion. Primary outcome was pain during LNG‐IUD insertion, while secondary outcomes were pain 10 min post‐procedure, ease of insertion, patient satisfaction, insertion time, and drug side effects.ResultsPain during LNG‐IUS insertion was reduced in LP group and misoprostol group compared to placebo group (2.1 ± 1.0 vs 3.7 ± 1.6; p <0.001) and (2.3 ± 1.3 vs 3.7 ± 1.6; p <0.001), respectively. Ease of procedure and patient satisfaction were significantly higher in LP and misoprostol groups than placebo (P <0.001). Need for additional analgesia was significantly higher in placebo group than in the other two groups (P = 0.009). Adverse events were not significantly different between the three groups except vomiting and abdominal cramps, which were higher with misoprostol.ConclusionLP cream and 200 μg of vaginal misoprostol administration before LNG‐IUD insertion in women delivered only by elective CD effectively reduced pain during insertion and 10 min post‐procedure with easier insertions, high patient satisfaction, and tolerable side effects. Pain reduction with LP cream was clinically significant.

show abstract

Efficacy and safety of oral vs vaginal misoprostol for cervical priming before hysteroscopy: A systematic review and meta-analysis

Cited by 11 publications

References 22 publications

Comparison of Misoprostol and Evening Primrose Oil on Cervical Preparation Before Gynecological Surgery

Comparison of Misoprostol and Evening Primrose Oil on Cervical Preparation Before Gynecological Surgery

Opinion paper: gynecological surgery in local anesthesia?

Comparative efficacy of lidocaine–prilocaine cream and vaginal misoprostol in reducing pain during levonorgestrel intrauterine device insertion in women delivered only by cesarean delivery: A randomized controlled trial

Contact Info

Product

Resources

About