title: Effectiveness of different routes of misoprostol administration before operative hysteroscopy: a randomized, controlled trial.
abstract: OBJECTIVE
  To compare the effectiveness and patient preference of different routes of misoprostol administration before operative hysteroscopy in premenopausal women.
  
  
  METHODS
  Randomized, controlled trial.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  One hundred sixty women undergoing operative hysteroscopy.
  
  
  METHODS
  Patients were randomly assigned to receive 400 μg misoprostol orally (n=40), sublingually (n=40), or vaginally (n=40) before operative hysteroscopy; the control group (n=40) did not receive any cervical priming agent.
  
  
  METHODS
  Preoperative cervical width, adverse effects, and patient preference.
  
  
  RESULTS
  The mean (±SD) cervical widths for the oral, sublingual, vaginal, and control groups were 7.62±1.81 mm, 7.58±1.77 mm, 7.60±2.15 mm, and 5.65±2.12 mm, respectively, which was statistically significant. Time to cervical dilatation was also significantly longer in the control group than in the other three groups. Misoprostol-related adverse effects and hysteroscopy-related complications were comparable among the four study groups. Of all 160 subjects, 132 (82%) preferred the oral route for misoprostol administration to the sublingual or vaginal routes, or had no preference.
  
  
  CONCLUSIONS
  All orally, sublingually, and vaginally administrated misoprostol is equally effective in inducing proper cervical priming before operative hysteroscopy. Considering patient preference, oral administration may be the optimal route for misoprostol administration.
  
  
  BACKGROUND
  NCT01805115.
authors.affiliation: Department of Obstetrics and Gynecology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Taejong
authors.initials: T
authors.lastname: Song
authors.affiliation: Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University, Seoul, South Korea.
authors.forename: Mi Kyoung
authors.initials: MK
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University, Seoul, South Korea.
authors.forename: Mi-La
authors.initials: ML
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University, Seoul, South Korea.
authors.forename: Yong Wook
authors.initials: YW
authors.lastname: Jung
authors.affiliation: Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University, Seoul, South Korea.
authors.forename: Bo Sung
authors.initials: BS
authors.lastname: Yoon
authors.affiliation: Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University, Seoul, South Korea. Electronic address: sjseongcheil@naver.com.
authors.forename: Seok Ju
authors.initials: SJ
authors.lastname: Seong
mesh_terms: D000282:Administration, Intravaginal; D000284:Administration, Oral; D000286:Administration, Sublingual; D000328:Adult; D004334:Drug Administration Schedule; D005260:Female; D006785:Hospitals, University; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects; D016595:Misoprostol / Q000008:administration & dosage* / Q000009:adverse effects; D010120:Oxytocics / Q000008:administration & dosage* / Q000009:adverse effects; D057240:Patient Preference; D011300:Preoperative Care; D011446:Prospective Studies; D056910:Republic of Korea; D013997:Time Factors; D016896:Treatment Outcome; D014599:Uterus / Q000187:drug effects* / Q000503:physiopathology / Q000601:surgery*
chemical_list: D010120:Oxytocics; D016595:Misoprostol
keywords: Misoprostol; cervical priming; cervical ripening; hysteroscopy