Randomized Comparative Study of 200 and 400 Micrograms Vaginal Misoprostol for Cervical Priming in Nonpregnant Nulliparous Women Undergoing Fractional Curettage

Abstract

Objective To compare the effectiveness of 200 and 400 mg of vaginal misoprostol inserted 6
hours prior to fractional curettage for pre - operative cervical dilatation.
Design Randomized comparative study.
Setting Department of Obstetrics and Gynecology at King Chulalongkorn Memorial Hospital.
Patients 50 non - pregnant nulliparous women with abnormal uterine bleeding and need to
undergo outpatient fractional curettage.
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 fractional curettage, two
tablets were inserted in the second group. Cervical dilatation was assessed by Hegar dilator
before and at 6 hours after misoprostol insertion.
Measurement and main results Baseline cervical dilatation were not significantly different before
misoprostol insertion. The mean of difference between pre and post - treatment cervical
dilatation in 400 mg misoprostol group was 3.80 ±1.29 mm and in 200 mg misoprostol group
was 1.96±0.68 mm, respectively. The cervical dilation was significantly increased when
compared with the 200 mg misoprostol group.( P < 0.001 ) None of the patients had significant
side effects.
Conclusion 400 mg vaginal misoprostol is more effective for pre - operative cervical dilatation in
6 hours than 200 mg vaginal misoprostol. No significant side effects were found in both
groups.