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Article: Oral misoprostol versus vaginal gemeprost for cervical dilatation prior to vacuum aspiration in women in the sixth to twelfth week of gestation

TitleOral misoprostol versus vaginal gemeprost for cervical dilatation prior to vacuum aspiration in women in the sixth to twelfth week of gestation
Authors
Issue Date1995
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/contraception
Citation
Contraception, 1995, v. 51 n. 6, p. 347-350 How to Cite?
AbstractThe effectiveness of oral misoprostol versus vaginal gemeprost for cervical dilatation prior to vacuum aspiration was compared in women in the 6th to 12th week of pregnancy. Sixty-four nulliparous women requesting termination of pregnancy between 6th to 12th weeks of gestation were randomized to receive either 400 μg misoprostol orally or 1 mg vaginal gemeprost at 12 hr or 3 hr prior to vacuum aspiration, respectively. The cervical dilatation at vacuum aspiration, the ease of the subsequent surgical procedure, and the incidence of complications and side effects were compared between these two methods of cervical priming. The median cervical dilatation at vacuum aspiration in the misoprostol group was significantly greater than that in the gemeprost group (8.0 mm versus 7.0 mm, p<0.02). Preoperative side effects were significantly less frequent in the misoprostol group (p<0.01). The ease of dilatation assessed subjectively by the operating surgeons was also improved significantly in the misoprostol group (p<0.01). However, the duration of operation and blood loss were similar in both groups. Since misoprostol is also much cheaper and more convenient to use, we conclude that oral misoprostol is better than vaginal gemeprost for cervical dilatation prior to vacuum aspiration in first trimester pregnancy. | Given the importance of adequate cervical dilatation to vacuum aspiration abortion, the effectiveness of oral misoprostol and vaginal gemeprost was compared. The 64 study subjects, all in the first 6-12 weeks of pregnancy, were randomly assigned either to take 400 mcg of misoprostol the night before pregnancy termination or were given 50 mg of vitamin B6 (placebo for misoprostol) to be taken the night before the procedure followed by vaginal insertion of 1 mg of gemeprost three hours preoperatively. Preoperative side-effects--nausea, vomiting, abdominal pain, and vaginal spotting--were significantly greater (p 0.01) in the gemeprost group; 28 out of 32 women in the misoprostol group compared to only 17 out of 32 in the gemeprost group experienced no side effects. The mean baseline cervical dilatation of 8.1 mm in the misoprostol group was significantly greater (p 0.01) than that in the gemeprost group (7.0 mm) and the ease of further dilatation was rated by surgeons as easier than normal for 87.5% of women in the former group compared to 59.4% in the latter group (p 0.01). The duration of the procedure and mean blood loss were similar in both groups. In addition to being more effective than gemeprost, misoprostol is less expensive and stable at room temperature. This is the first prospective, randomized study of oral as opposed to vaginal administration of misoprostol for cervical dilatation.
Persistent Identifierhttp://hdl.handle.net/10722/173212
ISSN
2015 Impact Factor: 2.788
2015 SCImago Journal Rankings: 1.557
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorNgai, SWen_US
dc.contributor.authorYeung, KCAen_US
dc.contributor.authorLao, Ten_US
dc.contributor.authorHo, PCen_US
dc.date.accessioned2012-10-30T06:28:33Z-
dc.date.available2012-10-30T06:28:33Z-
dc.date.issued1995en_US
dc.identifier.citationContraception, 1995, v. 51 n. 6, p. 347-350en_US
dc.identifier.issn0010-7824en_US
dc.identifier.urihttp://hdl.handle.net/10722/173212-
dc.description.abstractThe effectiveness of oral misoprostol versus vaginal gemeprost for cervical dilatation prior to vacuum aspiration was compared in women in the 6th to 12th week of pregnancy. Sixty-four nulliparous women requesting termination of pregnancy between 6th to 12th weeks of gestation were randomized to receive either 400 μg misoprostol orally or 1 mg vaginal gemeprost at 12 hr or 3 hr prior to vacuum aspiration, respectively. The cervical dilatation at vacuum aspiration, the ease of the subsequent surgical procedure, and the incidence of complications and side effects were compared between these two methods of cervical priming. The median cervical dilatation at vacuum aspiration in the misoprostol group was significantly greater than that in the gemeprost group (8.0 mm versus 7.0 mm, p<0.02). Preoperative side effects were significantly less frequent in the misoprostol group (p<0.01). The ease of dilatation assessed subjectively by the operating surgeons was also improved significantly in the misoprostol group (p<0.01). However, the duration of operation and blood loss were similar in both groups. Since misoprostol is also much cheaper and more convenient to use, we conclude that oral misoprostol is better than vaginal gemeprost for cervical dilatation prior to vacuum aspiration in first trimester pregnancy. | Given the importance of adequate cervical dilatation to vacuum aspiration abortion, the effectiveness of oral misoprostol and vaginal gemeprost was compared. The 64 study subjects, all in the first 6-12 weeks of pregnancy, were randomly assigned either to take 400 mcg of misoprostol the night before pregnancy termination or were given 50 mg of vitamin B6 (placebo for misoprostol) to be taken the night before the procedure followed by vaginal insertion of 1 mg of gemeprost three hours preoperatively. Preoperative side-effects--nausea, vomiting, abdominal pain, and vaginal spotting--were significantly greater (p 0.01) in the gemeprost group; 28 out of 32 women in the misoprostol group compared to only 17 out of 32 in the gemeprost group experienced no side effects. The mean baseline cervical dilatation of 8.1 mm in the misoprostol group was significantly greater (p 0.01) than that in the gemeprost group (7.0 mm) and the ease of further dilatation was rated by surgeons as easier than normal for 87.5% of women in the former group compared to 59.4% in the latter group (p 0.01). The duration of the procedure and mean blood loss were similar in both groups. In addition to being more effective than gemeprost, misoprostol is less expensive and stable at room temperature. This is the first prospective, randomized study of oral as opposed to vaginal administration of misoprostol for cervical dilatation.en_US
dc.languageengen_US
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/contraceptionen_US
dc.relation.ispartofContraceptionen_US
dc.rightsContraception. Copyright © Elsevier Inc.-
dc.subject.meshAbortifacient Agents, Nonsteroidal - Administration & Dosage - Pharmacology - Standardsen_US
dc.subject.meshAbortion, Induceden_US
dc.subject.meshAdministration, Intravaginalen_US
dc.subject.meshAdministration, Oralen_US
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshAlprostadil - Administration & Dosage - Analogs & Derivatives - Pharmacology - Standardsen_US
dc.subject.meshCervix Uteri - Drug Effects - Physiologyen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshMisoprostol - Administration & Dosage - Pharmacology - Standardsen_US
dc.subject.meshPregnancyen_US
dc.subject.meshPregnancy Trimester, First - Drug Effectsen_US
dc.subject.meshSuction - Methodsen_US
dc.subject.meshTime Factorsen_US
dc.titleOral misoprostol versus vaginal gemeprost for cervical dilatation prior to vacuum aspiration in women in the sixth to twelfth week of gestationen_US
dc.typeArticleen_US
dc.identifier.emailHo, PC:pcho@hku.hken_US
dc.identifier.authorityHo, PC=rp00325en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/0010-7824(95)00099-Ven_US
dc.identifier.pmid7554974-
dc.identifier.scopuseid_2-s2.0-0029024399en_US
dc.identifier.hkuros3072-
dc.identifier.volume51en_US
dc.identifier.issue6en_US
dc.identifier.spage347en_US
dc.identifier.epage350en_US
dc.identifier.isiWOS:A1995RC98900005-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridNgai, SW=7006074214en_US
dc.identifier.scopusauthoridYeung, KCA=21642798700en_US
dc.identifier.scopusauthoridLao, T=35327208900en_US
dc.identifier.scopusauthoridHo, PC=7402211440en_US

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