The Effect of Oral Misoprostol in Cervical Dilatation for Curettage and Hysteroscopy

Cho, G S; Kim, P K; Kim, J W; Hong, S I; Kang, Y H; Kim, T K

Abstract

OBJECTIVE
Recently, prostaglandins were used for cervical ripening and dilatation in pregnant women. However, its use in non-pregnant women is not well established. We compared pregnant versus non-pregnant woman for cervical ripening effect of oral misoprostol. Endometrial curettage and hysteroscopy are widely performed procedure in obstetrics and gynecology department. Difficulty in entering the internal os may be encountered, especially in nulliparous woman. The use of cervical priming agent is effective in reducing complications during cervical dilatation. We have used osmotic dilator[laminaria] for cervical dilatation prior to endometrial curettage and hysteroscopy. But laminaria is occasionally dangerous and uncomfortable to patient. We propose a new cervical priming agent[oral misoprostol] which is safe, cheap, comfortable and effective for cervical dilatation in both pregnant and non-pregnant woman.
METHODS
One hundred of patient requiring D&C and hysteroscopy were recruited for this study. The patients were received misoprostol 200microgram orally 12 hours before D&C and hysteroscopy. The effect of oral misoprostol was evaluated by number of Hegar dilator at operation room.
RESULTS
The mean Hegar dilator number with resistance[H] was 9.69, without resistance[M] was 7.9. In pregnant women, H = 10.2, M = 8.3. In nonpregnant women, H = 9.18, M = 7.5. In nullipara, H = 9.76, M = 7.88. In primipara, H = 10.1, M = 7.88. In multipara, H = 9.52, M = 7.98. Of total 100 cases, four cases were difficult to perform D&C and hysteroscopy because Hegar dilator number with resistance[H] was below 8. Overall success rate was 96%.
CONCLUSION
This study suggests that oral misoprostol is effective for cervical dilatation before curettage in both pregnant and non-pregnant women.