Misoprostol for cervical ripening in non-pregnant women: a randomized double-blind controlled trial of oral versus vaginal regimens

Clinical use of misoprostol for cervical ripening before transcervical procedures in non pregnant women: a randomized comparison of vaginal and sublingual administrations

“…3,5,12 A study by Batukean et al found that vaginal administration was more effective than the oral route for cervical ripening in non pregnant premenopausal women while the others found no difference between both the routes. 5 In addition, sublingual route was more effective when compared with vaginal and oral routes for pregnancy termination 8 .…”

“…In the above studies the time interval varied from 4-24 hours for oral and vaginal routes. 3,5,6 Lee et al used relatively shorter time interval of 6-8 hours. 12 The sublingual misoprostol was administered with an interval of 2-4 hours.…”

“…Clinical data suggest that the efficacy of 200mcg of vaginal misoprostol to 400mcg oral misoprostol is comparable with laminaria and is more effective than dinoprostone for cervical ripening before hysteroscopy. 3 The present study compared the sublingual and vaginal misoprostol with a dose of 400mcg 3-4 hours before procedure to reduce side effects and minimize the discomfort.…”

“…Batukan et al found that vaginal administration was more effective than the oral route for preoperative cervical ripening in non pregnant premenopausal women while the other studies have not found a difference between oral and vaginal routes. 3,5 Sublingual route was a better alternative for pregnancy termination however in non pregnant premenopausal women it was found that all three routes were comparable. 6 Various studies in premenopausal women have shown misoprostol is a cheap alternative to laminaria tent whereas in post menopausal women it failed to show the similar benefit.…”

“…As misoprostol is inexpensive, easy to use, cheap and has a long shelf life it has been employed as a cervical ripening agent before certain gynaecological procedures in order to reduce the complications occurring during the dilatation procedure. 3 Endometrial biopsy sometimes fails in nulliparous women due to difficulty in dilation of internal os. In postmenopausal patients the cervix may be small and endometrial biopsy is again difficult.…”