Caliskan E, Filiz T, Yucesoy G, Coskun E, Vural B, Corakci A
Department of Obstetrics and Gynaecology, Kocaeli University, School of Medicine, Kocaeli, Turkey.
Eur J Contracept Reprod Health Care. 2007 Dec;12(4):372-7. doi: 10.1080/13625180701549758.
To compare the effectiveness of sublingual and vaginal misoprostol application for cervical ripening prior to manual vacuum aspiration (MVA) under local anaesthesia for voluntary termination of pregnancy between 7 and 10 weeks of gestation.
Prospective randomized study in which 72 women were randomly assigned to administration of either 400 microg vaginal misoprostol 3 hours prior to or 200 microg sublingual misoprostol 2 hours prior to the surgical procedure. We took the preoperative cervical dilatation that was achieved as the main outcome measure. The duration of the procedure, intra-operative blood loss, pain perception before and during the operation, patients' satisfaction, side effects and duration of post-operative bleeding were secondary outcome measures.
A similar pre-operative cervical dilatation was achieved in the sublingual and the vaginal groups (6.9 +/- 1.6 mm and 6.6 +/- 1.1 mm, respectively; p = 0.3). The duration of the operation, intra-operative blood loss, and patients' satisfaction did not differ between the two groups. Pain scores were significantly higher in the sublingual group than in the vaginal group, both after administration of misoprostol (p = 0.02) and during the procedure (p = 0.02). Nausea and vaginal spotting were significantly more frequent (p = 0.01 and p = 0.003, respectively), but post-operative bleeding significantly shorter (p = 0.003) in the sublingual group.
Administration of 200 microg sublingual misoprostol 2 hours before suction curettage under local anaesthesia was as effective as 400 microg vaginal misoprostol 3 hours before that procedure with regard to achieving cervical dilatation. It resulted in higher pre-operative and intra-operative pain scores without changing patients' satisfaction.
比较在妊娠7至10周行局部麻醉下人工负压吸引术（MVA）终止妊娠前，舌下含服与阴道放置米索前列醇用于宫颈成熟的有效性。
前瞻性随机研究，72名妇女被随机分为两组，一组在手术前3小时阴道给予400微克米索前列醇，另一组在手术前2小时舌下含服200微克米索前列醇。我们将术前达到的宫颈扩张程度作为主要观察指标。手术时间、术中出血量、手术前后的疼痛感受、患者满意度、副作用及术后出血时间为次要观察指标。
舌下含服组和阴道放置组术前宫颈扩张程度相似（分别为6.9±1.6毫米和6.6±1.1毫米；p = 0.3）。两组的手术时间、术中出血量和患者满意度无差异。米索前列醇给药后（p = 0.02）及手术过程中（p = 0.02），舌下含服组的疼痛评分显著高于阴道放置组。舌下含服组恶心和阴道点滴出血明显更频繁（分别为p = 0.01和p = 0.003），但术后出血时间明显更短（p = 0.003）。
在局部麻醉下刮宫术前2小时舌下含服200微克米索前列醇与术前3小时阴道给予400微克米索前列醇在宫颈扩张方面效果相同。前者导致术前和术中疼痛评分更高，但不改变患者满意度。
