These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: Is misoprostol the drug of choice for induced cervical ripening in early pregnancy termination?
    Author: Platz-Christensen JJ, Nielsen S, Hamberger L.
    Journal: Acta Obstet Gynecol Scand; 1995 Nov; 74(10):809-12. PubMed ID: 8533565.
    Abstract:
    BACKGROUND: To study the effectiveness of three different cervical ripening agents in terms of dilatation ability and patient discomfort in connection with legal first trimester abortion. METHODS: Three randomized trials among unselected nulliparous women were performed 1: hygroscopic tent versus gemeprost, 2: misoprostol versus gemeprost and 3: misoprostol administered orally 17 versus 10 hours before vacuum curettage was performed. MAIN OUTCOMES: Dilatation ability, frequent gastrointestinal side effects, severe pain (patients' perception). RESULTS: In Trial 1, there was a tendency of a greater dilatation ability using the hygroscopic tent, while the experience of pain was a greater problem with gemeprost. In Trials 2 and 3, there were no significant differences in the dilatation abilities or gastrointestinal patient discomfort. There was a tendency towards a higher demand for narcotic analgesics in patients treated with gemeprost compared with all other groups. CONCLUSIONS: Gemeprost and misoprostol showed almost identical ability to dilate and caused patient-experienced discomfort to the same degree. The use of misoprostol may be preferred as it has the advantage of being both less expensive and easier to administer. The findings of three randomized trials of different cervical ripening agents indicate that misoprostol may be the preferred drug for use in vacuum aspiration abortion. Evaluated were the performances of the hygroscopic tent versus gemeprost, misoprostol versus gemeprost, and misoprostol administered orally 17 versus 10 hours before vacuum curettage. Included in the trials were 406 randomly selected nulliparous women presenting for first-trimester induced abortion at a Swedish hospital. The 3-mm hygroscopic tent was inserted by a physician 17-19 hours before vacuum aspiration. The gemeprost vaginal suppository was inserted by the patients 3-5 hours before the procedure, while subjects in the misoprostol trials took three 200 mcg tablets 8-10 or 17-19 hours before abortion. The degree of cervical dilatation was greater with the hygroscopic tent (mean, 8.8 mm) than gemeprost (6.3 and 6.6 mm in trials 1 and 2, respectively) and misoprostol (7.5 and 6.9 mm in trials 2 and 3, respectively). The severity of pain measure was similar in all 3 groups, although gemeprost acceptors required more parenteral narcotic analgesics. The duration of pain was positively linked to the time between treatment and abortion. There were 13 cases of postoperative pelvic inflammatory disease, but no correlation with cervical ripening technique. Despite the slightly greater dilatation associated with use of the hygroscopic tent, misoprostol is recommended given its lower cost, lack of need for refrigeration, and potential for patient rather than physician administration. There was no difference in dilatation when misoprostol was administered 10 hours as opposed to 17 hours before vacuum aspiration; thus, the former regimen is urged to reduce the duration of pain.
    [Abstract] [Full Text] [Related] [New Search]