The Effect of Various Dosages of Misoprostol for Cervical Preparation Before the Hysteroscopy

  Hysteroscopy is an impressive  diagnostic and therapeutic procedure for uterine cavity abnormalities. There are several methods for cervical preparation prior to hysteroscopy, among which misoprostol (a prostaglandin E1 analog) is the most common. However, misoprostol has some side effects, including uterine cramps, vaginal hemorrhage, nausea, vomiting, and fever-like feelings, the severity of which escalates by increasing the dosage. Therefore, in this study, we aimed to compare vaginal misoprostol in two different dosages of 200 and 400 μg with a control group to prescribe the lower dosage of misoprostol in case they were equally effective.

  In this randomized clinical trial study, 87 patients, who had hysteroscopy indications at Yas Hospital, were randomly assigned into three groups (i.e., 200 μg vaginal misoprostol, 400 μg vaginal misoprostol, and placebo). Afterward, the dilatation time of the cervical response and side effects associated with medication and surgery were assessed.

  The mean dilatation time in the 200 μg misoprostol, 400 μg misoprostol, and placebo groups were 46.7±35.8, 36.8±31.1, and 67.6±49.5 seconds, respectively. These differences were significant (P=0.038). 

  It seems that administering vaginal misoprostol is an easy, effective, and safe procedure  for cervical preparation before the hysteroscopy. Considering that increasing the dosage of misoprostol did not significantly change the dilatation time, it is recommended that 200 μg misoprostol be used to reduce the side effects.