Mathlouthi Nabil, Saodi Ola, Ben Temime Riadh, Makhlouf Tahar, Attia Leila, Chachia Abdellatif
Service de Gynecologie Obstetrique, CHU Charles Nicolle, Tunis, Tunisie.
Tunis Med. 2011 Nov;89(11):825-9.
To evaluate the benefits of cervical preparation with 200 mcg of Misoprostol administered 2 hours before diagnostic hysteroscopy.
Prospective randomized and double-blind study. A total of 108 patients were randomized into two groups: The first group G1 of 54 patients who received 200 mcg Misoprostol sublingually, two hours before diagnostic hysteroscopy, and a control group of 54 G2 patients without prior preparation. The surgeons were not informed before each act to which group the patient belongs. The parameters analyzed were: the rate of patients requiring dilation to Hegar candle to introduce the hysteroscope, hysteroscopy complications, and the side effects of Misoprostol.
In the Misoprostol group, 5 patients required the use of mechanical cervical dilatation (9.2%) against 12 patients (22.2%) in the control group. The average diameter of the larger candle used was 5.3 mm in the Misoprostol group against 4.2 mm in the control group. No significant difference was found between the two groups concerning the rate of complications in both procedures. By comparing the effect of Misoprostol in the group of postmenopausal women, no significant differences were observed regarding the use of cervical dilation or the rate of complications during hysteroscopy. Mor-over, no significant difference was observed in patients with a history of vaginal delivery.
No significant difference was noted in this study between Misoprostol group and control group, despite less use of cervical dilation and less complications in Misoprostol group.
评估在诊断性宫腔镜检查前2小时给予200微克米索前列醇进行宫颈准备的益处。
前瞻性随机双盲研究。总共108例患者被随机分为两组:第一组G1为54例患者,在诊断性宫腔镜检查前2小时舌下含服200微克米索前列醇;对照组G2为54例患者,未进行预先准备。在每次操作前,外科医生不知道患者所属的组。分析的参数包括:需要用Hegar扩宫棒扩张宫颈以插入宫腔镜的患者比例、宫腔镜检查并发症以及米索前列醇的副作用。
米索前列醇组有5例患者需要进行机械性宫颈扩张(9.2%),而对照组有12例患者(22.2%)。米索前列醇组使用的较大扩宫棒的平均直径为5.3毫米,对照组为4.2毫米。两组在两种操作的并发症发生率方面未发现显著差异。通过比较米索前列醇在绝经后女性组中的效果,在宫颈扩张的使用或宫腔镜检查期间的并发症发生率方面未观察到显著差异。此外,有阴道分娩史的患者也未观察到显著差异。
在本研究中,米索前列醇组和对照组之间未发现显著差异,尽管米索前列醇组宫颈扩张的使用较少且并发症较少。