Comparison of Effectiveness of Laminaria versus Vaginal Misoprostol for Cervical Preparation Before Operative Hysteroscopy in Women of Reproductive Age: A Prospective Randomized Trial
Autor: | Gonca İmir Yenicesu, Meral Cetin, Caglar Yildiz, Özlem Bozoklu Akkar, Savas Karakus, Ali Cetin |
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Přispěvatelé: | [Karakus, Savas -- Akkar, Ozlem Bozoklu -- Yildiz, Caglar -- Yenicesu, Gonca Imir -- Cetin, Meral -- Cetin, Ali] Cumhuriyet Univ, Sch Med, Dept Obstet & Gynecol, TR-58140 Sivas, Turkey, Cetin, Ali -- 0000-0002-5767-7894 |
Rok vydání: | 2015 |
Předmět: |
Adult
medicine.medical_specialty Visual analogue scale Cervical dilation Tissue Adhesions Cervix Uteri Hysteroscopy Operative hysteroscopy law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Laminaria dilator law Pregnancy Oxytocics Preoperative Care Medicine Humans Prospective Studies Prospective cohort study Misoprostol Pain Measurement Uterine Diseases Analgesics 030219 obstetrics & reproductive medicine Laminaria biology medicine.diagnostic_test business.industry Obstetrics and Gynecology Middle Aged biology.organism_classification Surgery Administration Intravaginal 030220 oncology & carcinogenesis Dilator Mechanical dilation Female business medicine.drug |
Zdroj: | Journal of minimally invasive gynecology. 23(1) |
ISSN: | 1553-4669 2627-2687 |
Popis: | WOS: 000368301700009 PubMed ID: 26272687 Study Objective: To compare the effectiveness and safety of intracervical laminaria dilator versus intravaginal misoprostol administered before surgery to facilitate cervical dilation before operative hysteroscopy. Design: A prospective randomized study (Canadian Task Force classification 1). Setting: A university hospital. Patients: A total of 150 women were assigned at random to the following groups: laminaria dilation (n = 50), misoprostol dilation (n = 50), and mechanical dilation (n = 50). Interventions: Hysteroscopic surgery of intrauterine lesions. Measurements and Main Results: In this study, 150 women were assigned at random to receive cervical priming with an intracervical laminaria dilator, 200 mu g of intravaginal misoprostol, or a mechanical dilator before operative hysteroscopy. Cervical response, surgical outcome, and complications of operative hysteroscopy were assessed. Visual analog scale (VAS) pain scores were recorded in the misoprostol and laminaria dilation groups. Demographic variables of the study groups were comparable (p = .278.988). The duration of cervical pretreatment was similar with the intracervical larminaria dilator and intravaginal misoprostol (p = .803); however, intravaginal misoprostol was associated with more adverse effects (p = .031). Compared with the misoprostol dilation group, in which all patients required additional cervical dilation, notably fewer patients in the laminaria dilation group required additional cervical dilation after cervical preparation (p = .001). VAS pain scores were significantly higher in the laminaria dilation group, however (p = .001). Conclusion: Cervical priming with an intracervical laminaria dilator before operative hysteroscopy reduces the need for cervical dilation and better facilitates hysteroscopic surgery compared with intravaginal misoprostol. Oral analgesic use may be required before the use of this device. Journal of Minimally Invasive Gynecology (C) 2016 AAGL. All rights reserved. |
Databáze: | OpenAIRE |
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