Barcaite E, Bartusevicius A, Railaite D R, Nadisauskiene R
Department of Obstetrics and Gynecology, Kaunas University of Medicine, Eiveniu 2, Kaunas 50009, Lithuania.
Int J Gynaecol Obstet. 2005 Nov;91(2):141-5. doi: 10.1016/j.ijgo.2005.06.019. Epub 2005 Aug 18.
To evaluate the effectiveness and possible adverse effects of vaginal misoprostol for cervical priming before hysteroscopy in perimenopausal and postmenopausal women.
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.
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.
Vaginal misoprostol applied before hysteroscopy reduced cervical resistance and the need for cervical dilation in perimenopausal and postmenopausal women, with only mild adverse effects.
评估米索前列醇阴道给药用于围绝经期和绝经后妇女宫腔镜检查前宫颈准备的有效性及可能的不良反应。
总共105例计划进行宫腔镜检查的妇女被随机分为2组。研究组（n = 51）在手术前至少12小时接受400微克米索前列醇阴道给药，对照组（n = 54）未使用宫颈准备药物。主要观察指标是需要宫颈扩张的妇女数量。次要观察指标包括宫颈宽度（无需阻力即可插入的最大Hegar扩张器尺寸）以及并发症和不良反应。
米索前列醇组有27名妇女（52.9%）需要宫颈扩张，而对照组为53名（98.1%）（P<0.0001）。米索前列醇组无需阻力即可插入的最大Hegar扩张器尺寸为7.6±1.4毫米，对照组为5.0±1.1毫米（P<0.0001）。在接受治疗的绝经后妇女亚组中也发现米索前列醇对宫颈扩张有类似效果。仅2名妇女（3.9%）在应用米索前列醇后出现轻度下腹痛。
宫腔镜检查前应用米索前列醇阴道给药可降低围绝经期和绝经后妇女的宫颈阻力及宫颈扩张需求，且仅有轻度不良反应。
