Effectiveness of misoprostol in office hysteroscopy in premenopausal nulliparous women: A prospective randomized double-blind placebo-controlled trial

Study Objective: The objective of this was to evaluate the effectiveness of misoprostol in premenopausal nulliparous women with 200-mcg single vaginal dose 4 h before the procedure. Design: This was a prospective randomized double-blind placebo-controlled trial. Setting: This study was conducted in...

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Main Authors: Vinod G Nair, Kallol Kumar Roy, Rakhi Rai, Anamika Das, Juhi Bharti, Rinchen Zangmo
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2020-01-01
Series:Journal of Human Reproductive Sciences
Subjects:
Online Access:http://www.jhrsonline.org/article.asp?issn=0974-1208;year=2020;volume=13;issue=2;spage=104;epage=109;aulast=Nair
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author Vinod G Nair
Kallol Kumar Roy
Rakhi Rai
Anamika Das
Juhi Bharti
Rinchen Zangmo
author_facet Vinod G Nair
Kallol Kumar Roy
Rakhi Rai
Anamika Das
Juhi Bharti
Rinchen Zangmo
author_sort Vinod G Nair
collection DOAJ
description Study Objective: The objective of this was to evaluate the effectiveness of misoprostol in premenopausal nulliparous women with 200-mcg single vaginal dose 4 h before the procedure. Design: This was a prospective randomized double-blind placebo-controlled trial. Setting: This study was conducted in a tertiary care and academic research center. Patients: One hundred patients were included in the study: 50 in misoprostol group and 50 in placebo. Interventions: Patients underwent office hysteroscopy 4 h after vaginal application of misoprostol or placebo. Measurements and Main Results: Ease of doing hysteroscopy was significantly better in the misoprostol group (difficulty score: 2.74 ± 1.20) as compared to placebo (difficulty score: 4.20 ± 1.10), P = 0.001. The time taken for negotiating the internal os (cervical passage time) was found to be significantly shorter in the misoprostol group (6.20 ± 5.21 s) as compared to placebo (14.78 ± 11.84 s), P = 0.001. The overall Visual Analog Scale (VAS) score was significantly lower in the intervention group (2.64 ± 1.62) as compared to placebo (4.90 ± 1.90), P = 0.001. Moreover, the VAS score at the point of passing internal os was significantly lower in the misoprostol group (2.82 ± 1.39) as compared to placebo (4.94 ± 1.96), P = 0.001. Misoprostol had a significant positive effect on satisfaction level of patients; 76% (n = 38) of women in the misoprostol group expressed their willingness to undergo the procedure again if required versus 18% (n = 9) in placebo, P = 0.001. Furthermore, 78% (n = 39) of women in the misoprostol group would recommend the procedure to their friends and relatives versus 36% (n = 18) in placebo, P = 0.001. Conclusion: Preoperative cervical preparation with 200 mcg of misoprostol vaginal application 4 h before office hysteroscopy in premenopausal nulliparous women significantly reduces the difficulty encountered in negotiating the cervical canal. Further, it significantly reduces the pain experienced by the patient at the point of passage through internal os as well as throughout the entire procedure.
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spelling doaj.art-267660aab6144c93afb89dbed21509352022-12-22T02:03:18ZengWolters Kluwer Medknow PublicationsJournal of Human Reproductive Sciences0974-12081998-47662020-01-0113210410910.4103/jhrs.JHRS_149_19Effectiveness of misoprostol in office hysteroscopy in premenopausal nulliparous women: A prospective randomized double-blind placebo-controlled trialVinod G NairKallol Kumar RoyRakhi RaiAnamika DasJuhi BhartiRinchen ZangmoStudy Objective: The objective of this was to evaluate the effectiveness of misoprostol in premenopausal nulliparous women with 200-mcg single vaginal dose 4 h before the procedure. Design: This was a prospective randomized double-blind placebo-controlled trial. Setting: This study was conducted in a tertiary care and academic research center. Patients: One hundred patients were included in the study: 50 in misoprostol group and 50 in placebo. Interventions: Patients underwent office hysteroscopy 4 h after vaginal application of misoprostol or placebo. Measurements and Main Results: Ease of doing hysteroscopy was significantly better in the misoprostol group (difficulty score: 2.74 ± 1.20) as compared to placebo (difficulty score: 4.20 ± 1.10), P = 0.001. The time taken for negotiating the internal os (cervical passage time) was found to be significantly shorter in the misoprostol group (6.20 ± 5.21 s) as compared to placebo (14.78 ± 11.84 s), P = 0.001. The overall Visual Analog Scale (VAS) score was significantly lower in the intervention group (2.64 ± 1.62) as compared to placebo (4.90 ± 1.90), P = 0.001. Moreover, the VAS score at the point of passing internal os was significantly lower in the misoprostol group (2.82 ± 1.39) as compared to placebo (4.94 ± 1.96), P = 0.001. Misoprostol had a significant positive effect on satisfaction level of patients; 76% (n = 38) of women in the misoprostol group expressed their willingness to undergo the procedure again if required versus 18% (n = 9) in placebo, P = 0.001. Furthermore, 78% (n = 39) of women in the misoprostol group would recommend the procedure to their friends and relatives versus 36% (n = 18) in placebo, P = 0.001. Conclusion: Preoperative cervical preparation with 200 mcg of misoprostol vaginal application 4 h before office hysteroscopy in premenopausal nulliparous women significantly reduces the difficulty encountered in negotiating the cervical canal. Further, it significantly reduces the pain experienced by the patient at the point of passage through internal os as well as throughout the entire procedure.http://www.jhrsonline.org/article.asp?issn=0974-1208;year=2020;volume=13;issue=2;spage=104;epage=109;aulast=Nairdifficultymisoprostoloffice hysteroscopyvisual analog scale score
spellingShingle Vinod G Nair
Kallol Kumar Roy
Rakhi Rai
Anamika Das
Juhi Bharti
Rinchen Zangmo
Effectiveness of misoprostol in office hysteroscopy in premenopausal nulliparous women: A prospective randomized double-blind placebo-controlled trial
Journal of Human Reproductive Sciences
difficulty
misoprostol
office hysteroscopy
visual analog scale score
title Effectiveness of misoprostol in office hysteroscopy in premenopausal nulliparous women: A prospective randomized double-blind placebo-controlled trial
title_full Effectiveness of misoprostol in office hysteroscopy in premenopausal nulliparous women: A prospective randomized double-blind placebo-controlled trial
title_fullStr Effectiveness of misoprostol in office hysteroscopy in premenopausal nulliparous women: A prospective randomized double-blind placebo-controlled trial
title_full_unstemmed Effectiveness of misoprostol in office hysteroscopy in premenopausal nulliparous women: A prospective randomized double-blind placebo-controlled trial
title_short Effectiveness of misoprostol in office hysteroscopy in premenopausal nulliparous women: A prospective randomized double-blind placebo-controlled trial
title_sort effectiveness of misoprostol in office hysteroscopy in premenopausal nulliparous women a prospective randomized double blind placebo controlled trial
topic difficulty
misoprostol
office hysteroscopy
visual analog scale score
url http://www.jhrsonline.org/article.asp?issn=0974-1208;year=2020;volume=13;issue=2;spage=104;epage=109;aulast=Nair
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