Misoprostol in Operative Hysteroscopy

Selk, Amanda; Kroft, Jamie

doi:10.1097/aog.0b013e31822f3c7b

Cited by 34 publications

(11 citation statements)

References 12 publications

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“…Compared with the placebo group, there was an increase in side effects (cramps, vaginal bleeding, nausea, and diarrhea) in the misoprostol group (relative risk [95%CI]: 4.28 [1.43–12.85]). 19 20…”

Section: Discussionmentioning

confidence: 99%

Misoprostol Administration Before Hysteroscopy Procedures – A Retrospective Analysis

Inácio

Troncon

Valério

et al. 2022

Rev Bras Ginecol Obstet

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Objective To evaluate the use of misoprostol prior to hysteroscopy procedures regarding technical ease, the presence of side effects, and the occurrence of complications. Methods This is a retrospective, observational, analytical, case-control study, with the review of medical records of 266 patients followed-up at the Gynecological Videoendoscopy Sector of the Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto of the Universidade de São Paulo (HCFMRP – USP, in the Portuguese acronym) from 2014 to 2019, comparing 133 patients who used the drug before the procedure with 133 patients who did not. Results The occurrence of postmenopausal uterine bleeding was the main indication for hysteroscopy and revealed a statistical difference between groups (p < 0.001), being present in 93.23% of the patients in the study group and in 69.7% of the patients in the control group. Only 2 patients (1.5%) in the study group reported adverse effects. Although no statistical differences were observed regarding the occurrence of complications during the procedure (p = 0.0662), a higher total number of complications was noted in the group that used misoprostol (n = 7; 5.26%) compared with the group that did not use the drug (n = 1; 0.75%), a fact that is clinically relevant. When evaluating the ease of the technique (measured by the complete performance of all steps of the hysteroscopy procedure), it was verified that although there was no difference between groups (p = 0.0586), the control group had more than twice as many incompletely performed procedures (n = 17) when compared with the group that used misoprostol previously (n = 8), which is also clinically relevant. Conclusion The use of misoprostol prior to hysteroscopy in our service indicated that the drug can facilitate the performance of the procedure, but not without side effects and presenting higher complication rates.

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Section: Discussionmentioning

confidence: 99%

Misoprostol Administration Before Hysteroscopy Procedures – A Retrospective Analysis

Inácio

Troncon

Valério

et al. 2022

Rev Bras Ginecol Obstet

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“…Misoprostol was initially approved for the prevention and treatment of peptic ulcers. However, misoprostol has been more frequently used in obstetrics/gynecology for cervical ripening and labor induction, although it is an off-label usage [ 1 2 3 4 5 ]. It is applied via the oral, sublingual, vaginal, and rectal routes, and compared to misoprostol administered orally, misoprostol administered via the sublingual and vaginal routes persists longer in the plasma [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…Misoprostol, a prostaglandin E 1 analog, is commonly used in obstetrics/gynecology clinics for various purposes, including induction of labor and dilatation of the cervix prior to intrauterine procedures, including dilatation and curettage or hysteroscopy [ 1 2 3 ]. Although extremely rare, life-threatening anaphylactic shock can occur after misoprostol administration.…”

Section: Introductionmentioning

confidence: 99%

Anaphylactic shock to vaginal misoprostol: a rare adverse reaction to a frequently used drug

et al. 2018

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Misoprostol is widely used in daily practice for induction of labor and cervical dilatation prior to intrauterine procedures, including dilatation and curettage or hysteroscopy. Anaphylactic shock to intravaginal misoprostol can occur not only in pregnant women, as reported in 2 previous cases, but also in a non-pregnant, perimenopausal woman, as in the case described herein. A 49-year-old woman received vaginal misoprostol for cervical ripening prior to hysteroscopic myomectomy and experienced anaphylactic shock. Two 400 μg doses of misoprostol 6 hours apart caused uncontrolled shaking and high fever followed by shock. In conclusion, the possibility of anaphylactic shock should be considered in patients with sudden hypotension following misoprostol administration. Prompt identification and management are crucial to prevent morbidity and mortality following an anaphylactic shock to misoprostol.

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“…A single trial that examined the preoperative administration of misoprostol well before (8–12 hours) outpatient hysteroscopy did show benefit in reducing intraoperative pain, perhaps suggesting the importance of timing of administration (39). However, given the side effect profile of a single dose of misoprostol (nausea, vomiting, diarrhea, abdominal cramping, fever (40,41)), and the limited data suggesting benefit, this medication should probably not be used routinely for patients undergoing these procedures in the outpatient setting.…”

Section: Non-opioid Analgesicsmentioning

confidence: 99%

Perioperative pain management strategies among women having reproductive surgeries

Prabhu

Bortoletto

Bateman

2017

Fertility and Sterility

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In this review, we present opioid-sparing strategies for perioperative pain management among women undergoing reproductive surgeries and procedures. We provide recommendations regarding the use of nonsteroidal anti-inflammatory drugs, acetaminophen, other adjunctive medications, and regional anesthetic blocks. We discuss additional considerations for chronic opioid users or patients using opioid replacement or antagonist therapy.

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Misoprostol in Operative Hysteroscopy

Cited by 34 publications

References 12 publications

Misoprostol Administration Before Hysteroscopy Procedures – A Retrospective Analysis

Misoprostol Administration Before Hysteroscopy Procedures – A Retrospective Analysis

Anaphylactic shock to vaginal misoprostol: a rare adverse reaction to a frequently used drug

Perioperative pain management strategies among women having reproductive surgeries

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