Vaginal Misoprostol Prior to Curettage for Cervical Dilatation in Perimenopausal Women: A Randomized Controlled Trial

Abstract

Objective To compare the effectiveness of vaginal misoprostol and placebo inserted 6 hours prior to curettage for pre-operative cervical dilatation.

Design                Randomized comparative study.

Setting                Department of Obstetrics and Gynaecology, King Chulalongkorn Memorial Hospital.

Subjects Twenty-six perimenopausal women who underwent outpatient curettage during January 2003 to June 2003.

Intervention Subjects were randomly assigned into two groups. In the first group, one tablet of 200 mg misoprostol was inserted in posterior fornix 6 hours prior to curettage. One tablet of placebo (vitamin B6) was inserted in the second group. Cervical dilatation was assessed by Hegar dilator before and at 6 hours after misoprostol or vitamin B6 insertion.

Measurement and main results Baseline cervical dilatation were no statistically significant difference between two groups. The mean differences of post-pre treatment cervical dilatation were 1.85+0.99 mm and 0.38+0.51 mm in misoprostol and placebo group, respectively. The cervical dilatation was significantly increased in misoprostol group compared to placebo group (p < 0.001). None of the patients had clinically significant side effects.

Conclusion Vaginal misoprostol of 200 mg was effective for pre-curettage cervical dilatation in
perimenopausal women. No clinically significant side effects were found in this setting.