title: Vaginal misoprostol for cervical priming before hysteroscopy in perimenopausal and postmenopausal women.
abstract: OBJECTIVE
  To evaluate the effectiveness and possible adverse effects of vaginal misoprostol for cervical priming before hysteroscopy in perimenopausal and postmenopausal women.
  
  
  METHODS
  A total of 105 women scheduled for hysteroscopy were randomly assigned to 2 groups. The study group (n=51) received 400 microg of vaginal misoprostol at least 12 h before the procedure and the control group (n=54) received no cervical priming agent. The primary outcome measure was the number of women who required cervical dilation. Secondary outcomes were cervical width (the largest size of Hegar dilator inserted without resistance) as well as complications and adverse effects.
  
  
  RESULTS
  In the misoprostol group 27 women (52.9%) required cervical dilation vs. 53 (98.1%) in the control group (P<0.0001). The largest size of Hegar dilator inserted without resistance was 7.6+/-1.4 mm in the misoprostol group vs. 5.0+/-1.1 mm in the control group (P<0.0001). A similar effect of misoprostol on cervical dilation was also found in the subgroup of treated postmenopausal women. Only 2 women (3.9%) experienced mild lower abdominal pain after misoprostol application.
  
  
  CONCLUSIONS
  Vaginal misoprostol applied before hysteroscopy reduced cervical resistance and the need for cervical dilation in perimenopausal and postmenopausal women, with only mild adverse effects.
authors.affiliation: Department of Obstetrics and Gynecology, Kaunas University of Medicine, Eiveniu 2, Kaunas 50009, Lithuania. eglebarcaite@yahoo.com
authors.forename: E
authors.initials: E
authors.lastname: Barcaite
authors.forename: A
authors.initials: A
authors.lastname: Bartusevicius
authors.forename: D R
authors.initials: DR
authors.lastname: Railaite
authors.forename: R
authors.initials: R
authors.lastname: Nadisauskiene
mesh_terms: D000282:Administration, Intravaginal; D000368:Aged; D002584:Cervix Uteri / Q000187:drug effects*; D004106:Dilatation; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000379:methods*; D008875:Middle Aged; D016595:Misoprostol / Q000627:therapeutic use*; D010120:Oxytocics / Q000627:therapeutic use*; D047648:Perimenopause; D017698:Postmenopause; D011292:Premedication; D011300:Preoperative Care
chemical_list: D010120:Oxytocics; D016595:Misoprostol