Mifepristone does not induce cervical softening in non-pregnant women.
BACKGROUND
Many techniques have been developed to soften the cervix to reduce complications following surgical dilatation. Progesterone inhibits myometrial contractility and its secretion during pregnancy ensures cervical competence. We used the progesterone antagonist mifepristone as a cervical ripening agent and evaluated its effect prior to office hysteroscopy.


METHODS
Fifty-eight healthy non-pregnant women aged 18-50 were studied in a randomized double-blind study. They received mifepristone (200 mg) or placebo 30 h prior to hysteroscopy. A Hegar test was performed prior to drug administration and again before hysteroscopy. A visual analogue pain scale was used to assess pain.


RESULTS
Medical history, physical examination and blood tests were similar in both groups, except for serum progesterone which was higher in the study group. Hegar measurement prior to drug ingestion was similar in both groups and after a mean time of 30.3 h increased in both groups. Neither the DeltaHegar measurement nor the pain scale was different in the two groups. There was also no effect of the high progesterone levels.


CONCLUSIONS
Unlike its dramatic effect in the pregnant uterus, mifepristone administered 30 h prior to hysteroscopy was not effective in ripening the cervix of non-pregnant women.
Women's Health Center-Ramat Eshkol, Department of Obstetrics and Gynecology, and Institute of Hormone Research, Shaare Zedek Medical Center, Jerusalem, Israel. benchet@023.net.il
Avraham
A
Ben-Chetrit
Talia
T
Eldar-Geva
Tzina
T
Lindenberg
Morshed
M
Farhat
Shlomo
S
Shimonovitz
David
D
Zacut
Hadassa
H
Gelber
Regine
R
Sitruk-Ware
Irving M
IM
Spitz
D000328:Adult; D002584:Cervix Uteri / Q000187:drug effects*; D004311:Double-Blind Method; D005260:Female; D006727:Hormone Antagonists / Q000627:therapeutic use*; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects; D008875:Middle Aged; D015735:Mifepristone / Q000627:therapeutic use*; D010146:Pain / Q000209:etiology / Q000503:physiopathology; D010147:Pain Measurement; D011292:Premedication; D011374:Progesterone / Q000097:blood; D017211:Treatment Failure
D006727:Hormone Antagonists; D015735:Mifepristone; D011374:Progesterone